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.

Other Voices

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How long can osteosarcoma last?

Osteosarcoma, also known as osteogenic sarcoma, commonly occurs in adolescents, especially in children and teenagers under the age of 20. It is one of the most malignant tumors among bone tumors, with most patients dying within six months to a year. However, early detection and treatment can potentially extend survival. The survival period of osteosarcoma depends on the location of the tumor; the closer to the distal extremities, the longer the survival period after treatment; the closer to the trunk, even with treatment, the survival period is not very long.

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Characteristics of Osteosarcoma

Osteosarcoma is a malignant tumor of the bone that primarily occurs in adolescents and young adults, commonly found at the metaphyseal ends of long bones. For example, it may occur at the distal end of the tibia, the distal end of the femur, or the metaphyseal end of the humerus. Clinically, the main symptom is pain, which is persistent and more noticeable at night, accompanied by a local mass, limited movement, increased local skin temperature, distended veins, and general symptoms such as weight loss and even cachexia. Some patients may experience pathological fractures. Often, there are no symptoms in the early stages, and by the time it is detected, it is usually in an intermediate or advanced stage. Radiographic examination typically shows a Codman's triangle or sunburst pattern. Early detection and treatment are crucial. The usual treatment choice is surgical, such as deactivation and reimplantation, or limb-salvage surgery with prosthetic implantation. Additionally, amputation followed by extensive chemotherapy is another option. With recent advances in chemotherapy, there has been significant improvement in life extension.

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incidence of osteosarcoma

Osteosarcoma, also known as osteogenic sarcoma, is a primary malignant tumor of the bone and has a relatively high incidence rate. Among primary bone tumors, the incidence of osteosarcoma is second only to plasma cell myeloma, ranking second. Osteosarcoma typically occurs in tubular bones, commonly affecting the rapidly growing metaphyseal regions. The distal femur, proximal tibia, and proximal humerus are the most frequently affected sites. Between 50%-70% of all cases occur around the knee joint. The common age range for this disease is between 10 to 20 years old, with a higher prevalence in males than in females.

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Do benign osteosarcomas use chemotherapy?

First of all, all osteosarcomas are malignant; osteosarcoma is a type of malignant tumor with no benign variant. Regarding the treatment of osteosarcoma, the first step is chemotherapy. After confirming the diagnosis through pathological examination and confirming it is osteosarcoma, The first step is chemotherapy, which can stabilize the tumor cells; Then, the main tissue is surgically removed, as well as the surrounding infiltrated soft tissue; The third step is to use chemotherapy again to eliminate the residual cancer cells. This treatment protocol of chemotherapy-surgery-chemotherapy is currently the most common and advanced method in the country. It can significantly improve the patient's survival rate, reduce the risk of amputation, and can also prevent the recurrence of osteosarcoma.

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Osteosarcoma is a type of cancer.

Osteosarcoma is a relatively common type of malignant bone tumor in clinical practice. It mainly occurs near the ends of the humerus, including the area around the head of the humerus, and at the distal end of the femur, near the femoral condyles, as well as the proximal tibia, close to the tibial plateau. These are its common sites. It predominantly affects teenagers, generally those under 18 years of age. The main symptoms include: firstly, persistent and worsening pain that gradually intensifies and does not alleviate, with the notable characteristic being that the pain is more severe at night than during the day; secondly, the appearance of spindle-shaped tumors around the joints, particularly at the three aforementioned common sites, often accompanied by redness, warmth, pain in the superficial skin, and even prominent superficial veins; thirdly, osteosarcoma is a type of malignant tumor, classified as grade 2B among malignant tumors. Its main feature, apart from local symptoms, is its propensity for metastasis, with the lungs being the most likely site of metastasis.