Clinical Pathways
Clinical Pathways
No limited range of motion
No limited range of motion

No limited range of motion

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Action

Obtain radiographs (strongly consider with chronic, focal symptoms)

Decision

Are the findings concerning for a malignant lesion?

Yes

  • Discuss with orthopedic oncology and pediatric oncology
  • Disposition pending specific lesion and consult recommendations

No

  • Discuss with pediatric orthopedics; likely discharge

Background

Radiographic features of benign and malignant lesions (see Table 2, page 8 for additional details)

Benign:

  • Well-defined margins
  • Smooth, uninterrupted periosteal reaction
  • Bone destruction confined to focal area of tumor
  • Absence of soft-tissue mass

Malignant:

  • Poorly defined borders
  • Irregular, interrupted periosteal reaction
  • Bone destruction is more widespread
  • Presence of extraosseous extension or a soft-tissue mass outside of the bone

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References
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