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Bony and Spinal Metastasis

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • The skeleton is one of the most common sites for metastatic cancer.

  • Bone metastasis can cause significant morbidity including pain, pathologic fractures, spinal cord compression, and ...

DIAGNOSIS

HISTORY

  • Previous cancer diagnosis or treatment

  • Pain is the most common presenting symptom.

  • Occupational and exposure history

    • Signs and symptoms specific to organs to help identify primary site

PHYSICAL EXAM

TREATMENT

GENERAL MEASURES

Treatment depends on many factors including histology, site of disease, extent of epidural disease, extent of metastasis, and neurologic compromise from metastasis (1,5)[C]. 
  • ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Regular follow-up with oncology and other members of patient cancer care team

  • PT

  • Assistive devices to help reduce fracture risk

Patient Monitoring

Regular labs and sc...

REFERENCES

1
Smith HS, Mohsin I. Painful boney metastases. Korean J Pain.  2013;26(3):223–241. {L-End} [View Abstract on OvidMedline]
2
Suva LJ, Washam C, Nicholas RW, et al. Bone metastasis: mecha...

CODES

ICD10

C79.51 Secondary malignant neoplasm of bone 

ICD9

198.5 Secondary malignant neoplasm of bone and bone marrow 

SNOMED

  • 94222008 Secondary malignant neoplasm of bone (disorder)

  • 94602001 Secondary m...

CLINICAL PEARLS

  • Include metastatic cancer in the differential diagnosis of unexplained musculoskeletal pain in adults.

  • Opioids are the mainstay of pain treatment for metastatic bone disease.

  • Start bisph...

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