Bone tumors: Pathology review


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Bone tumors: Pathology review

Musculoskeletal system

Pediatric musculoskeletal conditions

Radial head subluxation (Nursemaid elbow)

Developmental dysplasia of the hip

Legg-Calve-Perthes disease

Slipped capital femoral epiphysis

Transient synovitis

Osgood-Schlatter disease (traction apophysitis)

Musculoskeletal injuries and trauma

Rotator cuff tear

Dislocated shoulder

Radial head subluxation (Nursemaid elbow)

Winged scapula

Thoracic outlet syndrome

Carpal tunnel syndrome

Ulnar claw

Erb-Duchenne palsy

Klumpke paralysis

Iliotibial band syndrome

Unhappy triad

Anterior cruciate ligament injury

Patellar tendon rupture

Meniscus tear

Patellofemoral pain syndrome

Sprained ankle

Achilles tendon rupture



Degenerative disc disease

Spinal disc herniation


Compartment syndrome


Bone disorders

Osteogenesis imperfecta


Pectus excavatum


Genu valgum

Genu varum

Pigeon toe

Flat feet

Club foot

Cleidocranial dysplasia



Bone tumors




Osteomalacia and rickets


Paget disease of bone


Lordosis, kyphosis, and scoliosis

Joint disorders



Spinal stenosis

Rheumatoid arthritis

Juvenile idiopathic arthritis


Calcium pyrophosphate deposition disease (pseudogout)

Psoriatic arthritis

Ankylosing spondylitis

Reactive arthritis


Septic arthritis


Baker cyst

Muscular disorders

Muscular dystrophy



Inclusion body myopathy

Polymyalgia rheumatica



Neuromuscular junction disorders

Myasthenia gravis

Lambert-Eaton myasthenic syndrome

Other autoimmune disorders

Sjogren syndrome

Systemic lupus erythematosus

Mixed connective tissue disease

Antiphospholipid syndrome

Raynaud phenomenon


Limited systemic sclerosis (CREST syndrome)

Musculoskeletal system pathology review

Back pain: Pathology review

Rheumatoid arthritis and osteoarthritis: Pathology review

Seronegative and septic arthritis: Pathology review

Gout and pseudogout: Pathology review

Systemic lupus erythematosus (SLE): Pathology review

Scleroderma: Pathology review

Sjogren syndrome: Pathology review

Bone disorders: Pathology review

Bone tumors: Pathology review

Myalgias and myositis: Pathology review

Neuromuscular junction disorders: Pathology review

Muscular dystrophies and mitochondrial myopathies: Pathology review


Bone tumors: Pathology review

USMLE® Step 1 questions

0 / 9 complete


USMLE® Step 1 style questions USMLE

of complete

A 67-year-old man comes to the clinic due to progressive fatigue and back pain over the past few months. Initially, the patient attributed the pain to strenuous work in the garden but decided to seek care when he noticed no improvement. The patient also noted a 10 lb (4.5 kg) weight loss without changes in his diet. Medical history is significant for smoking 1 pack of cigarettes per day for 35 years and diabetes mellitus type 2. Laboratory values are obtained and shown below:  
 Laboratory value  Result 
 Hemoglobin  11.2 g/dL 
 Mean corpuscular hemoglobin   90 fl 
 Creatinine   2.3 mg/dL 
 Total protein  9.5 
 Albumin  3.2 g/dL 
 Sodium   132 mEq/L 
 Potassium   4.2 mEq/L 
 Chloride   95 mEq/L 
 Calcium  12 mg/dl  

Radiograph of the spine reveals multiple areas of hyperlucency at the lumbar and thoracic regions. Which of the following is the most likely underlying cause? 


Content Reviewers

Yifan Xiao, MD


Jung Hee Lee, MScBMC

Daniel Afloarei, MD

Kaylee Neff

Tanner Marshall, MS

While doing your rounds, you see two individuals. First is James, a 14-year-old boy who came in for chronic right knee pain, night sweats, and weight loss. He didn’t report falling or any other trauma to the region or any additional symptoms. On examination, his right knee is slightly larger than the left and, on palpation, a hard mass can be felt on the metaphysis of his right femur, close to the knee region. Then you see William, who’s 22 years old and complains of a 1-month history of bone pain along his left tibia, a problem which is worse at night. One interesting observation he made was that the pain responds well to Ibuprofen, a nonsteroidal anti-inflammatory drug. On examination, palpation reveals a bony mass on the anterior surface of the left tibial diaphysis. As expected, X-ray scans were obtained. They showed a distal sunburst appearance and Codman's triangle in James’ right femur, whereas William’s x-ray scans detected a small lesion under 2 centimeters with a radiolucent core on the anterior surface of his left tibia.

Now, both seem to have some type of bone tumor. But first, a bit of physiology. Even though the bones vary in size and shape, all bones are made of the same types of cells, and chief among them are osteoblasts which build up new bone, and osteoclasts which help with bone breakdown or resorption. Now in addition to these, there are some more primitive cells in the bone marrow called human mesenchymal stem cells and neuroectodermal cells, which can differentiate into many cell types including nerve, fat, bone, and cartilage cells. In terms of anatomy, looking at a long, bone like the femur, it has two epiphysis, which are the ends that contribute to joints with other bones. Between the two epiphyses, is the diaphysis, also called the bone shaft. In children and adolescents, there is an additional narrow portion between the epiphysis and the diaphysis called the metaphysis. The metaphysis contains the growth plate, the part of the bone that grows during childhood. In adults, the growth plate has ossified and fused with the diaphysis and the epiphysis.


Bone tumors can be either benign (non-cancerous) or malignant (cancerous), and can occur in any bone in the body. Bone tumors may be caused by several different factors, including genetics, infection, trauma, and exposure to radiation or certain chemicals.

Benign bone tumors include osteochondroma, giant-cell tumor, osteoid osteoma, and osteoblastoma. Malignant bone tumors include osteosarcoma, Ewing sarcoma, and chondrosarcoma


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  12. " Pathobiology and Diagnosis of Multiple Myeloma" Semin Oncol Nurs. (2017)
  13. "Multiple myeloma: from diagnosis to treatment" Aust Fam Physician (2013)

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