osteosarcoma X-ray presentation

Written by Li Xin
Pediatric Orthopedics
Updated on January 28, 2025
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The variations in the X-ray appearance of osteosarcoma are quite large, but the basic characteristics are a mix of osteolytic destruction and pure bony changes. In most cases, besides the mixed changes, there is also destruction of the bone cortex and invasion of soft tissues, with visible periosteal reaction. The epiphysis has a certain blocking effect on the tumor, hence it rarely crosses the epiphyseal line. On the X-ray, changes indicative of skip metastasis can be seen, along with typical Codman's triangle or sunburst patterns. Beneath the periosteum, there are fine, needle-like sunburst radiating changes, which are fairly typical radiographic changes of osteosarcoma and are generally used to diagnose the condition.

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Written by Guan Jing Tao
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Can osteosarcoma patients eat mangoes?

Patients with osteosarcoma are advised to follow a light diet and eat more vegetables. Fruits should mainly consist of common ones, including apples and other fruits. Although mango is a tropical food and can be consumed occasionally without major impact, it is still advisable to avoid excessive consumption. It is also appropriate to consume some nutritional health foods, such as multivitamins or high-quality protein powder, which can better enhance one's immunity. Additionally, it is important to maintain a joyful mood. The diet should primarily avoid spicy and irritating foods, as well as bad habits like drinking alcohol, smoking, and staying up late.

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How to prevent osteosarcoma

From the perspective of osteosarcoma itself, prevention should involve active exercise, a healthy lifestyle, and a regular schedule. All of these can play a preventive role. However, as of now, there is no clear cause of what triggers osteosarcoma, and it is still unknown. For patients with osteosarcoma, we need to achieve early diagnosis and early treatment. Since many osteosarcomas occur in adolescents, if your child complains of bone pain and feels lumps, and more severely, experiences joint functional impairment, parents must be vigilant. It is advised for the patient to go to a hospital and have an imaging test done to confirm if it is caused by osteosarcoma. Therefore, early diagnosis and early treatment are best.

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Written by Guan Yu Hua
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Why does osteosarcoma not hurt?

Osteosarcoma usually presents with pain, which is often severe, persistent, and most pronounced at night. The local skin temperature may also increase, accompanied by venous obstruction. It is a malignant tumor of the bone, most commonly located near the proximal part of the tibia or the distal part of the femur. The main symptom is pain, and a definite diagnosis can be made through radiographic examination, such as sunlight exposure, Codman's triangle, etc. In its early stages, osteosarcoma can metastasize. If there is no pain, it may be due to individual variations in the disease. However, the first symptoms of malignant bone tumors are usually pain and a palpable mass. Radiographic examinations will show changes. If osteosarcoma is confirmed and there is no pain, it could be related to the disease not having progressed to a more severe stage, possibly indicating an early stage. Early aggressive surgical treatment is recommended, such as limb-sparing surgery, devitalization and reimplantation, or prosthetic implantation. Another option is amputation. Osteosarcoma has a relatively high chance of metastasizing to the lungs; therefore, early surgery, early diagnosis, and rapid chemotherapy are essential, as these can significantly increase the five-year survival rate.

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Do osteosarcomas hurt?

The early symptoms of osteosarcoma include pain, which initially is intermittent. As the condition progresses, this intermittent pain gradually becomes constant, and the intensity of the pain is parallel to the severity of the osteosarcoma, meaning the more severe the osteosarcoma, the more intense the pain. Additionally, you can also feel a lump forming on the affected limb, and this lump is clearly tender to touch. The third symptom is the occurrence of a limp. This limp is due to pain, which prevents the patient from bearing weight and walking for extended periods. Lastly, all osteosarcomas present symptoms such as anemia, pathologic fractures, and a low-grade fever.

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Is osteosarcoma serious?

Osteosarcoma is a fairly serious condition. It is a type of malignant bone tumor and is classified as stage II according to the Eric staging system. Regardless of the treatment method used for osteosarcoma, the first issue is that it metastasizes quickly, and the second is that it tends to recur frequently. Therefore, once someone has osteosarcoma, it poses significant challenges, not only being difficult to treat but also involving considerable treatment costs. However, thanks to the efforts of researchers, a new adjuvant chemotherapy has been developed which has increased the five-year survival rate of osteosarcoma from 47% to about 80%, which is quite remarkable. Moreover, with this new adjuvant chemotherapy, patients first undergo chemotherapy, followed by surgery, during which chemotherapy is administered again, not only improving the five-year survival rate but also enhancing the quality of life for patients. Therefore, osteosarcoma is a very serious disease. In the past, amputation was common, followed by distal metastasis, so it didn't take long for metastases to appear in the lungs or brain. Thus, osteosarcoma is an extremely serious disease.