Summary
Definition
History and exam
Key diagnostic factors
- childhood and adolescence
- worsening pain over weeks to months
- mass/swelling
- male sex
Other diagnostic factors
- race/ethnicity
- tall stature
- high birthweight
- limp
- history of trauma
- limited range of motion
Risk factors
- childhood and adolescence
- Paget disease
- radiation therapy
- Rothmund-Thomson syndrome
- familial retinoblastoma syndrome
- Li-Fraumeni syndrome
- race/ethnicity
- nonfamilial deleterious germline variants
- male sex
- tall stature
- high birthweight
- chemotherapy exposure
Diagnostic tests
1st tests to order
- conventional radiographs
- bone biopsy
- magnetic resonance imaging (MRI)
- computed tomography (CT)
- CT thorax
- bone scan
- whole body fluorodeoxyglucose (FDG)-PET/CT
- complete blood count
- serum alkaline phosphatase
- serum lactate dehydrogenase
Treatment algorithm
Contributors
Authors
David Loeb, MD, PhD
Chief
Division of Pediatric Hematology, Oncology, and Marrow & Blood Cell Transplantation
Children's Hospital at Montefiore
Associate Professor, Pediatrics
Associate Professor, Developmental and Molecular Biology
Albert Einstein College of Medicine
Bronx
NY
Disclosures
DL declares that he has no competing interests.
Acknowledgements
Dr David Loeb would like to gratefully acknowledge Dr Luminita Rezeanu and Dr Michael J. Klein, the previous contributors to this topic.
Disclosures
LR and MJK declare that they have no competing interests.
Peer reviewers
Edward Sauter, MD, PhD
Professor of Surgery
Ellis Fischel Cancer Center
University of Missouri
Columbia
MO
Disclosures
ES declares that he has no competing interests.
Rachael Windsor, BSc, MBBS, MSc, MRCPCH
Locum Consultant Paediatric Oncologist
University College Hospital
London
UK
Disclosures
RW declares that she has no competing interests.
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