Benign Osteolytic Lesions in Children With Previously Normal Radiographs

Tan, Emily B.; Mehlman, Charles T.; Baker, Michael

doi:10.1097/bpo.0000000000000918

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…In their early stages, the diseases are often asymptomatic. Patients with early symptoms frequently do report to their doctors, but a lack of characteristic symptoms delays the right initial and further diagnoses [5].…”

Section: Discussionmentioning

confidence: 99%

The Epidemiology of Benign Proliferative Processes of the Skeletal System in Children

Rutkowski

Niewinska

2021

IJERPH

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A suspicion of a proliferative bone lesion in a child seems to be a major diagnostic problem for clinicians. There are no diagnostic and treatment algorithms described in the literature and no reliable cohort epidemiological data. Our study was conducted among 289 paediatric patients (0–18 years old) with an initial diagnosis of a bone tumour or tumour-like lesion. The study comprised a retrospective epidemiological analysis, an assessment of the concordance of the initial diagnoses with the histopathological diagnoses and an analysis of the specific locations of the various bone lesions. The results obtained have made it possible to formulate the following conclusions. (1) The most common proliferative bone lesion in children is osteochondroma; also common are fibrous dysplasia, non-ossifying fibromas and bone cysts. (2) Verifying the initial diagnosis by means of biopsy is essential. (3) Osteochondromas are typically located in the metaphyses of long bones, fibrous dysplasia in the femur and skull, cyst-like lesions in the proximal humerus and non-osteochondral fibromas exclusively in the lower limbs. What could improve the quality of treatment for children with primary proliferative bone diseases is the establishment of centres of paediatric orthopaedic oncology skilled in early diagnosis and prompt management.

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Section: Discussionmentioning

confidence: 99%

The Epidemiology of Benign Proliferative Processes of the Skeletal System in Children

Rutkowski

Niewinska

2021

IJERPH

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Bone Tumor Risk Stratification and Management System: A Consensus Guideline from the ACR Bone Reporting and Data System Committee

Caracciolo,

Ali,

Chang

et al. 2023

Journal of the American College of Radiology

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The Natural History of Benign Bone Tumors of the Extremities in Asymptomatic Children

Collier

Nelson

Conry

et al. 2021

Journal of Bone and Joint Surgery

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Background: Benign bone tumors are common incidental findings in the pediatric population during radiographic evaluation. Counseling these patients requires reassurance and raises questions about the natural history of these tumors over time. The purpose of this study was to estimate the prevalence and observe the behavior of benign childhood bone tumors in an asymptomatic population. Methods: A historical, longitudinal radiographic collection of healthy children was reviewed, which included comprehensive left-sided radiographs of the extremities at yearly intervals. In this study, 262 subjects with 25,555 radiographs were screened for benign bone tumors at a median age of 8 years (range, 0 to 18 years). All potential tumors were reviewed by a multidisciplinary panel, which confirmed the radiographic diagnosis of each lesion, the age at which the lesion first appeared, and the age at which it had resolved. Prevalence rates were calculated using the number of distinct subjects available for each radiographic location and age. Results: Thirty-five tumors were identified in 33 subjects, including 19 nonossifying fibromas, 8 enostoses, 6 osteochondromas, and 2 enchondromas. The prevalence rate for all tumors combined increased with age and was 18.9% overall. The overall prevalence rates for specific tumor types were 7.5% for nonossifying fibromas, 5.2% for enostoses, 4.5% for osteochondromas, and 1.8% for enchondromas. Nonossifying fibromas demonstrated a bimodal distribution of prevalence, with a peak at 5 years (10.8%) and another after skeletal maturity (13.3%). The median age at the first appearance for all tumors combined was 9 years (range, 2 to 15 years), but varied by tumor type. Nonossifying fibromas often resolved (7 [37%] of 19), with further resolution possible beyond the last available radiograph. Enostoses, osteochondromas, and enchondromas persisted until the last available radiographs in all subjects. Conclusions: The prevalence of benign childhood bone tumors of the extremities was 18.9% in a historical asymptomatic population. Longitudinal radiographs allowed observation of the timing of the first appearance and the potential for resolution for each tumor type. These findings provide unique evidence to answer many commonly encountered questions when counseling patients and their families on benign bone tumors. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Benign Osteolytic Lesions in Children With Previously Normal Radiographs

Abstract: Radiographs taken before diagnosis in children with osseous lesions are rare, but likely under recognized. Further studies of such instances in larger databases may provide a noninvasive means to reach diagnostic or etiologic conclusions.

Cited by 3 publications

References 6 publications

The Epidemiology of Benign Proliferative Processes of the Skeletal System in Children

The Epidemiology of Benign Proliferative Processes of the Skeletal System in Children

Bone Tumor Risk Stratification and Management System: A Consensus Guideline from the ACR Bone Reporting and Data System Committee

The Natural History of Benign Bone Tumors of the Extremities in Asymptomatic Children

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