Diagnosis of early osteosarcoma

Early detection, diagnosis and treatment of osteosarcoma play a crucial role in the cure of the disease. In order to enable more osteosarcoma patients to diagnose their condition as soon as possible and receive symptomatic treatment as soon as possible according to their condition, let us learn about the diagnosis method of early osteosarcoma.

Clinically, osteosarcoma often occurs in adolescents, less in the mandible and more in the maxilla, with a history of injury. Early symptoms are intermittent numbness and pain in the affected area, which then turns into persistent severe pain accompanied by reflex pain; the tumor grows rapidly, destroying the alveolar process and jawbone, causing loose and displaced teeth, facial deformities, and pathological fractures. On X-rays, it appears as irregular destruction, and those that expand from the inside to the outside are osteolytic; those with cortical bone destruction and replacement with hyperplastic bone in a solar radiation arrangement are osteoblastic. Clinically, a mixed type with both of the above types can also be seen. In the late stage, serum calcium and alkaline phosphatase may be elevated in patients, and the tumor is easily metastatic to the lungs along the blood vessels.

The course of the disease varies from a few days to several years from the onset of symptoms to the time of treatment, with an average of 3 to 4 months. The most common site is around the knee joint. The earliest clinical symptom is pain, which is mostly dull and persistent, and the pain worsens after activity. The pain is more obvious at night. A lump appears in the affected area, and the growth rate of the lump is often measured in months. When the lump increases significantly, reactive effusion may occur in the adjacent joints, and joint movement is limited. Early pain often occurs suddenly after a minor injury. The swelling starts mildly and gradually worsens, presenting an eccentric spindle-shaped swelling. The hardness of the lump varies, depending on the texture of the tumor. Osteolytic lesions are softer than osteoblasts. The skin of the affected area is shiny, the surface veins are dilated, and the skin temperature rises. If the tumor is large and adjacent to the joint, it may affect joint function. Some patients have metastases to other parts when they seek medical treatment.

The size of the tumor may vary depending on the depth of the tumor and the extent of the soft tissue invaded by the tumor. The tumor is locally tender and its hardness varies depending on the amount of bone tissue contained in the tumor. When the tumor is large, blood vessels on the skin surface may become dilated.

The most typical site of disease is the tubular bones of the limbs (accounting for 80%), especially the femur (40%), tibia (16%) and humerus (15%). The distal femur, proximal tibia and proximal humerus are the most common sites. 50% to 75% of osteosarcomas occur near the knee joint. Osteosarcoma in the fibula, hip, mandible, maxilla and spine is relatively rare. Osteosarcoma of the skull, ribs, scapula, clavicle, sternum, ulna, radius and small bones of the hands and feet is rare. In long tubular bones, osteosarcoma mainly occurs in the epiphyseal region. Osteosarcoma occurring in the diaphysis accounts for about 2% to 11%. Osteosarcoma can spread to the epiphysis, especially after the epiphyseal plate is closed, but osteosarcoma occurring at the bone end is very rare. Epiphyseal osteosarcoma (epiphysealosteosarcoma) is mainly seen in the femoral condyle.

Diseases can cause us harm to varying degrees. Clinically, osteosarcoma causes pain and swelling in the bone ends of the knee joints of adolescents. Most cases can be diagnosed based on medical history, physical signs, X-rays, radionuclide bone scans, CT, MRI, and laboratory tests. Biopsy can be performed when necessary. Attention should be paid to distinguishing from the following lesions: myositis ossificans, tuberculous osteitis of the metacarpals and metatarsal bones (osteosarcoma rarely occurs here), chronic osteomyelitis, bone cysts, and giant cell tumors.