Benign vs malignant leg pain Flashcards
benign vs malignant leg pain at night
benign - wakes suddely w cramp like pain
-returns to sleep with simple measures
malignant- unable to sleep - pain unremitting
benign vs malignant leg pain initial managment
benign
- resolves w simple measures like pains, returns to sleep with simple measures
malignant-
- deep boring pain
-unresponse to simple measaures or simple pain releif medication
benign vs malignant leg pain function
benign - returns to nromal the next day
malignant - functional impact/loss of function/altered function
benign vs malignant leg pain site
benign - often bilateral or changes site on differnet occasions
malignant- unilateral , same focus
benign vs malignant leg pain age of patient
benign - usually primary scholl age kids
malignant
-tumours- more often adolescent
leukaemia- any age
Neuroblastoma- pre-school
benign vs malignant (6) leg pain examiniation
benign- examination normal
malignant
- area of pain/tenerness on examation
-mass on examination (boen tumour)
-metaphyseal tenderness (marrow infiltration)
postural shift- child alters how they sit/stand/dress/walk
neurological features
systemic features - weight loss, fever, bruisoing, anaemia
benignleg pain investiagions
benign - investigaitons normal
bone tumour investigation findings 2
x-ray changes
acute phase response
Acute lymphblastic luekaemia investigation findings 2
signs of marrow failure
infiltration on blood film (may not alwasy be present)
-increased acute phase response
neuroblastoma investigation findings 3
evidence of marrow infiltration
metastatic tumour on imaging
urinary VMAs and HVAs (catecholamine products)