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Bony and Spinal Metastasis

Anna T.H. Bui, MD Reviewed 06/2021
 


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)[C],(5...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

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

  • PT

  • Assistive devices to help reduce fracture risk

Patient Monitoring

R...

REFERENCES

1
Smith  HS, Mohsin  I. Painful boney metastases. Korean J Pain.  2013; 26(3): 223– 241.  [View Abstract]
2
...

CODES

ICD10

C79.51 Secondary malignant neoplasm of bone 

SNOMED

  • 94222008 Secondary malignant neoplasm of bone (disorder)

  • 94602001 Secondary malignant neoplasm of vertebral column (disorder)

  • 285618001 Metas...

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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