Bone Pain - Week 13 PBL

Question 1

Presentation of bone pain?

Answer 1

Deep, constant pain
Muscle weakness
Widespread bone pain
Bone deformities
Fractures

Question 2

Initial investigation of bone pain?

Answer 2

Bloods: Ca, Phosphate, ALP and LFT, Vit D, PTH
X-ray
DEXA
History

Question 3

Red flags of bone pain?

Answer 3

History of malignancy
Weight loss
Night sweat
Night pain
Pain that is progressive/persistent
Any history of recent trauma
Symmetrical joint swelling

Question 4

Key differentials for bone pain?

Answer 4

Rickets
Bone cancer
Metastatic cancer
Infection
Osteoporosis
Osteomalacia
OA, RA etc
Pagets
Osteoporosis

Question 5

Initial treatment for bone pain?

Answer 5

NSAIDs for pain relief
Nutrition supplements - for those with osteoporosis and vitamin D deficiency
Antibiotics - for bone infections
Cancer treatments like surgery radiation therapy or chemotherapy