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Royal Orthopaedic Hospital Child Bear

Symptoms and Diagnosis

Pain is the most common symptom of bone cancer however symptoms may vary depending on the location and size of the tumour. Patients usually present with pain, swelling, and sometimes decreased joint motion or tenderness around the affected area and more commonly, a fracture or break at the tumour site. Symptoms are usually present for several months before the diagnosis is made and about 15-20 percent of the patients have metastatic disease (Secondary Cancer) at the time of diagnosis – usually in the lung and other bones. Whilst these symptoms are common in many other conditions and more often than not, have no relation to Osteosarcoma, persistent bone pain, particularly at night, should always be consulted by a GP.

The pre-diagnosis of a patient with suspected Osteosarcoma typically includes blood tests, plain x-rays and magnetic resonance imaging (MRI) of the affected bone, computerized tomography (CT) scan of the chest, a PET (positron emission tomography) scan or PET-CT scan and a radionuclide bone scan however a biopsy is always required to make full diagnosis. It is preferable to have the biopsy done by the surgeon who will ultimately perform the surgical treatment. Fine-needle aspiration and core-needle biopsies are sometimes recommended but most patients require open biopsy to obtain a generous sample of adequate and representative tissue.

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