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Tumours of the musculo-skeletal system (ASSESSMENT AND COMMON FINDINGS…
Tumours of the musculo-skeletal system
CAUSES
the cause of primary bone cancer is unknown
same cancers are hereditary
condition such as Paget's diseases can under go malignant transformation with resultant bone tumours
ASSESSMENT AND COMMON FINDINGS
pain, swelling and restricted movement
pathological fracture may results in metastasis
diagnostic investigation such as X-rays may reveal impending of existing pathological fractures
MRI and CT scans can also delineated the invasion of the tumour in to the bone and soft tissues
neddle biopsy will confirm the presence of malignant cells
THERAPEUTIC MANAGENT
Surgery
Chemotherapy
Radiation
TYPES OF TUMOURS
CARTILAGE
Osteochondroma
DIAGNOSTIC MODE- Osteochondroma grows at the edge of the epiphyseal plate can be deected by X-ray
Chondroma
MALIGNANT- Chondrosarcoma
DIAGNOSTIC MODE- Chondroma: X-ray shows specks of calcification, usually in phalangeal bone
Chondrosarcoma: X-ray and CT scan will show a destrictive tumour will specks of calcification, chondrosarcoma affects large bones
PRESENTATION - Pain, swelling and the bone became porous and may sustain fractures with trivial injuries
MANAGEMENT- Surgical removal of affected parts and bone graft, and radiotherapy
PRESENTATION - lump on the metaphysis of a long bone MANAGEMENT - surgical removal of affected area
BONE
Osteoid osteoma
Osteosarcoma
DIAGNOSTIC MODE- Osteoid osteoma; X-ray shows a small radiolucent area surrounded by dense sclerosis
Osteosarcoma; X-ray shows a combination of bone destruction and bone formation. CT scan and MRI usually outline the extent of the tumour
Biopsy is necessary to confirm the diagnisis
PRESENTATION- Pain that is relieved by analgesia, increasing pain
MANAGEMENT-Analgesia, cytotoxic drugs and radiotherapy
BONE MARROW
EOSINOPHILIC GRANULOMA
MALIGNANT- Ewing's sarcoma
DIAGNOSTIC MODE- Ewing's sarcoma; X-ray shows bone destruction
myeloma; the tumour arises from the plasma cells of the bone marrow, X-ray may shows vertebral compression fractures
sternal bone marrow biopsy will shows typical myeloma cells.
PRESENTATION-malignant tumour arising from the vascular endothelium in the bone marrow, present with pain and swelling
MANAGEMENT- amputation and radiotherapy and chemotherapy
MYELOMA- pain and spinal pathological fractures
fractures are support in brace and radiotherapy and chemotherapy
UNCERTAIN
GIANT-CELL TUMOUR
MALIGNANT-giant- cell tumour
DIAGNOSTIC MODE- X-ray shows a rarefied area at the end of a long bone
the cells are invasive and metastasis while in others remain benign
PRESENTATION- Pain and swelling near the affected joint and pathological fracture may occur
MANAGEMENT- removal of the affected part and bone graft is recommended