0 Item(s)
Management of Metastases and Neoplasms in the Hip
Tumor destruction of bone can be the result of a primary benign or malignant bone tumor or can occur secondary to metastatic bone disease. Although metastatic bone disease is far more common, primary bone tumors may be encountered in any orthopaedic practice. Suspicion of neoplasm should be elevated if the patient has progressive pain that is unrelieved by rest and is most pronounced at night. Because up to 50% loss of trabecular bone can occur before lesions are visualized on plain radiographs, a neoplasm diagnosis should be high on the list of differential diagnoses for the patient who has a radiograph that appears to be negative for neoplasm but does not respond to therapies that have been deemed appropriate for the working diagnosis. Tumors that cause a permeative pattern of bone destruction, such as lymphoma and Ewing sarcoma, often are very difficult to identify on plain radiographs. In the patient with continued symptoms (particularly if the symptoms are progressive), repeat plain radiographs are recommended, and bone scintigraphy or MRI can be helpful.