How to diagnose osteosarcoma?

Written by Wang Cheng Lin
Orthopedics
Updated on June 12, 2025
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For the examination of osteosarcoma, the first step is to take an X-ray, which can show changes in the bone quality. At the same time, it is necessary to perform a CT scan or MRI to clarify the nature of this bone tumor and its extent, or whether there is any distant metastasis. The third method is a nuclear bone scan, which mainly detects whether there are any early distant metastatic lesions. Of course, in clinical practice, the gold standard for diagnosing osteosarcoma relies on the examination of living tissue. That is, to perform a surgery, carry out a minor operation to obtain a little tissue from the bone tumor, and then send it for pathological examination to determine the nature of the tumor. This is the gold standard for diagnosing osteosarcoma.

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Written by Na Hong Wei
Orthopedics
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Can osteosarcoma be felt?

Osteosarcoma can be felt by touch, and its main clinical manifestations include persistent progressive pain, which intensifies at night. Secondly, there are local lumps, commonly located at the distal femur, proximal tibia, and proximal humerus, which are high incidence areas for osteosarcoma. In such cases, you don't even need to touch it; you can see it with the naked eye because the swelling is quite severe. Additionally, the surrounding skin may appear reddened and warm, and superficial veins may become prominently swollen, indicating that the skin over the affected area looks different from normal skin. Moreover, in the area affected by osteosarcoma, the bone may show a spindle-shaped enlargement, looking like a spindle-shaped lump, causing the joint area and the surrounding normal joints to be clearly abnormal. Therefore, in cases of obvious symptoms of osteosarcoma, not only can you see the tumor, but you can also feel it. However, patients often will not let you touch it, as touching can cause pain and even force the joint and surrounding muscles into a forced state. This forced condition helps alleviate pain in the joint and surrounding areas. Thus, osteosarcoma can indeed be felt by touch.

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Written by Wang Cheng Lin
Orthopedics
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What are the symptoms of osteosarcoma?

Symptoms of Osteosarcoma: The first is pain at the site of occurrence. This pain may be intermittent and not very pronounced in the early stages. As the condition progresses, the severity of the pain gradually increases, transitioning from intermittent to persistent pain; The second is the formation of a lump. You can feel a lump on the limb with your hand, and this lump is clearly tender to the touch; The third is limping, which is mainly caused by the pain in the limb; The fourth is the most common systemic symptoms. Patients with this malignant tumor will exhibit fever, weight loss, anemia, and pathological fractures. These are the main symptoms of osteosarcoma currently observed in clinical settings.

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Written by Wang Cheng Lin
Orthopedics
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What is the metastatic pathway of osteosarcoma?

Osteosarcoma commonly spreads in three ways. The first is through hematogenous dissemination, meaning that tumor cells spread throughout the body via the bloodstream, a process known as hematogenous spread. The second method is called implantation metastasis, where tumor cells directly implant in the common sites of osteosarcoma, leading to localized disease. The third type is lymphatic spread, where tumor cells spread to multiple parts of the body through the lymphatic system, causing new tumor growth. These three pathways are the most common routes of metastasis seen clinically in osteosarcoma, with hematogenous spread being the most frequent.

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Written by Li Jie
Orthopedics
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incidence of osteosarcoma

Osteosarcoma, also known as osteogenic sarcoma, is a primary malignant tumor of the bone and has a relatively high incidence rate. Among primary bone tumors, the incidence of osteosarcoma is second only to plasma cell myeloma, ranking second. Osteosarcoma typically occurs in tubular bones, commonly affecting the rapidly growing metaphyseal regions. The distal femur, proximal tibia, and proximal humerus are the most frequently affected sites. Between 50%-70% of all cases occur around the knee joint. The common age range for this disease is between 10 to 20 years old, with a higher prevalence in males than in females.

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Written by Peng Li Bo
Oncology
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Is chondrosarcoma cancer?

Chondrosarcoma is broadly cancer, but in medical terms, we wouldn’t necessarily phrase it that way; we simply describe chondrosarcoma as a type of malignant tumor, and currently, its treatment outcomes are not very good. Generally, when we talk about cancer, we’re referring to malignant tumors that originate from epithelial tissue, including cancers like stomach cancer, lung cancer, colon cancer, and liver cancer, which all derive from epithelial tissues. However, because chondrosarcoma originates from mesenchymal tissue, which includes muscle, cartilage, blood vessels, and nerves, malignant tumors that occur in these areas are usually called sarcomas. Sarcomas are definitely malignant, but to strictly call them cancer is not particularly precise.