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When Danger Lurks: Recognizing when it’s More than a Sports I njury. Fazel A. Khan, MD Musculoskeletal Oncology & Joint Replacement Dept of Orthopedic Surgery Stony Brook University Hospital. Background: Musculoskeletal Cancers.
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When Danger Lurks: Recognizing when it’s More than a Sports Injury Fazel A. Khan, MD Musculoskeletal Oncology & Joint Replacement Dept of Orthopedic Surgery Stony Brook University Hospital
Background: Musculoskeletal Cancers • Average delay in diagnosis for a primary bone or soft tissue sarcoma is 3 to 7 months • Why? RARE tumors LOW index of suspicion • 500 cases per year of osteosarcoma • 5000 cases per year of soft tissue sarcoma • Compare to incidence of meniscus tears, rotator cuff, degenerative disease
History is the most important thing • History of trauma, preceding symptoms prior to trauma • Insidious onset • Night pain • Associated symptoms
Cementation of defect ischial fixation
popliteal artery and vein (in sheath) popliteal artery popliteal vein sciatic nerve tibial nerve common peroneal nerve
tumor cut surface of femur vessels and nerves
Summary • Simple History alone can clue the medical provider to the fact that one may be dealing with something other than the usual non-neoplastic musculoskeletal problem • Trauma? • Antecedent pain? • Associated symptoms • Progressive worsening with conservative treatment?