Benign bone tumors are noncancerous growths of bone or cartilage, most often found in children and young adults. Many are found by chance on an X-ray, and the key task is to tell them apart from cancer.
Key symptoms
- Often none; found on an X-ray taken for another reason
- Dull bone pain; night pain relieved by NSAIDs suggests osteoid osteoma
- A hard, painless lump near a joint, as in osteochondroma
- Sudden pain after a minor injury from a pathologic fracture
What you find on exam
- Firm, fixed mass near the end of a long bone
- Tenderness and swelling at the site
- Joint range of motion and limb alignment
- Nerve and blood vessel function if the mass presses nearby
Tests
- Plain X-ray: sharp edges, a thin sclerotic rim and no periosteal reaction suggest a benign lesion
- CT or MRI to define the lesion
- Biopsy if the X-ray looks aggressive
Treatment basics
- Watchful waiting with repeat X-rays for lesions without symptoms
- NSAIDs or radiofrequency ablation for osteoid osteoma
- Surgical removal or curettage with bone graft if painful, growing or weakening the bone
- Fixation of pathologic fractures
Red flags
- Rapid growth, poorly defined edges or periosteal reaction on X-ray
- Weight loss, night sweats or fever
- Pain that keeps getting worse
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.