Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about osteosarcoma in children. And you can find written notes on this topic at

zero definals.com slash osteosarcoma or in the orthopedic section of the Zero to Finals

Pediatrics book.

So let's get straight into it.

Osteosarcoma is a type of bone cancer.

It usually presents in adolescents and younger adults aged 10 to 20 years.

The most common bone to be affected is the femur.

Other common sites are the tibia and the humorous.

So how does it present?

The main presenting feature is persistent bone pain, particularly worse at night time.

This may disturb or wake them from sleep.

Other symptoms that may be present include bone swelling, a palpable mass and restricted joint

movements.

Let's talk about establishing the diagnosis.

The nice guidelines recommend a very urgent direct access x-ray within 48 hours for children presenting with unexplained bone

pain or swelling. If the x-ray suggests possible sarcoma, they need very urgent specialist

assessment within 48 hours. X-rays show a poorly defined lesion in the bone with destruction

of the normal bone and a fluffy

appearance. There will be a periostial reaction which is irritation of the lining

of the bone that is classically described as a sunburst appearance. There can be an

associated soft tissue mass also seen on the x-ray.

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