- Diff Dx: Painful Joint:
- four conditions may cause an excruciatingly painful joint;
-
infection
- Gout or, rarely, Pseudogout;
-
Rheumatic Fever;
- Tumor;
- Diff Dx Tumor:
-
osteoid osteoma
-
Osteosarcoma
-
chondrosarcoma
-
Chondroblastoma
-
Fibrosarcoma of bone
-
Fibrous Dysplasia
-
Giant Cell Tumor of Bone
-
Eosinophilic granuloma
-
Ewing's sarcoma
-
Reticulum cell sarcoma
- Discussion: Painful Tumors:
- clinical features associated with bone tumors include pain,
deformity, and impairment of function;
- pain is feature common to almost all malignant tumors of bone,
but may or may not be present in benign lesions;
- malignant bone tumors are usually associated with deep, aching pain,
which, although not sharp and sometimes not severe, is quite
distressing to the patient because of its constancy;
- pain that persists at night and is not relieved by rest is suggestive of
malignancy; however, certain benign tumors, such as
osteoid osteoma,
are characterized by nocturnal pain;
- mild, dull, aching back pain that suddenly becomes excruciating w/ such
insignificant trauma as sitting down a bit hard suggests
pathologic compression frx in vertebra involved by
metastatic cancer;