Orthopaedic Oncosurgery – Joint Warning Signs

Joint problems have become common in today’s era. With technology, any joint problem is treatable but it needs to be detected at the right time. We take the saying ‘Ignorance is bliss’ too seriously, especially when it comes to our joints. Never ignore joint problems as it can become a torture. Warning signs like pain around the joint areas, a palpable swelling or the requirement to take an analgesic medicine especially in children or adolescents does warrant check up by your orthopaedic surgeon. Radiographs or X-rays of the local area of concern form the first line of investigation.

Any suspicion of a neoplastic lesion should form a timely referral to a sarcoma or cancer centre or to an orthopaediconcosurgeon who is trained in dealing with such lesions and where subsequent treatment will be carried out.This practice by the local physician or the local orthopaedic surgeon should be in the best interest of the child and his/her family and forms a vital part in the ultimate successful management of such patients.

Blue arrow showing a suspicious bone lesion in the distal part of the thigh bone/femur in X-RAY in an adolescent child complaining of pain in the lower thigh region for the past 1 month

Next part of managementis at a sarcoma/ cancer centre and mainly involves the role of an orthopaedic oncosurgeon, a radiologist and an onco-pathologist trained in sarcomas. The child will be clinically examined by the orthopaedic oncosurgeon and some more local imaging in the form of a contrast enhanced MRI may be ordered.

Bone Biopsy forms the next part of management in which some material from the suspicious lesion is obtained. This procedure is routinely done under sedation on a day care basis with same day admission and discharge. A core needle biopsy should be performed by Ortho-Oncosurgeon who is routinely handling such cases as it forms a vital part of the subsequent diagnosis and management of the patient. This procedure is completely safe and pain-free provided it is carried out a centre where all the expertise is available for handling such cases.