Can osteosarcoma be seen on an X-ray?

Written by Guan Jing Tao
Orthopedics
Updated on May 12, 2025
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Osteosarcoma can be detected through characteristic changes in X-ray imaging, such as the Codman's triangle, which usually occurs around the joints at the metaphyseal ends of the long tubular bones in the limbs. This leads to the destruction of the trabeculae and increased density of the tumor tissue, which can break through the cortical bone. The tumor can lift the periosteum to form the characteristic Codman's triangle. Therefore, orthopedic doctors can preliminarily diagnose it as a bone tumor or osteosarcoma based on the appearance in this X-ray. Additionally, diagnosis should be correlated with clinical symptoms such as the presence of a noticeable mass, pain, tenderness in the localized area, and general symptoms of cachexia, such as weight loss, anemia, fever, and malaise.

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Written by Guan Yu Hua
Orthopedic Surgery
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Why does osteosarcoma not hurt?

Osteosarcoma usually presents with pain, which is often severe, persistent, and most pronounced at night. The local skin temperature may also increase, accompanied by venous obstruction. It is a malignant tumor of the bone, most commonly located near the proximal part of the tibia or the distal part of the femur. The main symptom is pain, and a definite diagnosis can be made through radiographic examination, such as sunlight exposure, Codman's triangle, etc. In its early stages, osteosarcoma can metastasize. If there is no pain, it may be due to individual variations in the disease. However, the first symptoms of malignant bone tumors are usually pain and a palpable mass. Radiographic examinations will show changes. If osteosarcoma is confirmed and there is no pain, it could be related to the disease not having progressed to a more severe stage, possibly indicating an early stage. Early aggressive surgical treatment is recommended, such as limb-sparing surgery, devitalization and reimplantation, or prosthetic implantation. Another option is amputation. Osteosarcoma has a relatively high chance of metastasizing to the lungs; therefore, early surgery, early diagnosis, and rapid chemotherapy are essential, as these can significantly increase the five-year survival rate.

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Written by Na Hong Wei
Orthopedics
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What are the symptoms of osteosarcoma?

The main symptom of osteosarcoma is localized pain, primarily at the distal end of the femur, the proximal end of the tibia, and the proximal end of the humerus. This pain tends to worsen continuously, with nighttime pain often more severe than during the day, which is a significant characteristic of osteosarcoma. The second symptom is the presence of a local mass, which is often spindle-shaped and generally located near a joint. This mass often leads to limited joint mobility, and the skin over the mass typically has a high temperature. Sometimes, it may also be accompanied by visible swelling of superficial veins. The third symptom involves systemic cachexia, which includes unexplained weight loss, generalized weakness, and even an anemic condition. The fourth point pertains to osteolytic osteosarcoma, which often leads to bone destruction, reduced bone strength, and consequently, even minor external forces can cause fractures. These are called pathological fractures. Thus, the symptoms of osteosarcoma generally include these four points.

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Written by Zhang Ying Peng
Orthopedics
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How long can osteosarcoma last?

Osteosarcoma, also known as osteogenic sarcoma, commonly occurs in adolescents, especially in children and teenagers under the age of 20. It is one of the most malignant tumors among bone tumors, with most patients dying within six months to a year. However, early detection and treatment can potentially extend survival. The survival period of osteosarcoma depends on the location of the tumor; the closer to the distal extremities, the longer the survival period after treatment; the closer to the trunk, even with treatment, the survival period is not very long.

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

The symptoms of recurrent osteosarcoma include the following points: Firstly, if osteosarcoma recurs, it can cause sudden severe pain in the affected limb. This pain tends to intensify as the disease progresses and may shift from intermittent pain to continuous pain. Secondly, there might be metastasis to the lungs or other parts of the body. In such cases, if lung metastasis occurs, the patient will experience significant chest tightness and breathing difficulties. Thirdly, recurrent osteosarcoma can also lead to weight loss, decreased appetite, and the occurrence of low-grade fever. Fourthly, if the tumor recurs, the patient’s joints and the affected limb's mobility will be significantly hindered, and this can also cause numbness in the affected limb.

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Can osteosarcoma occur on the knee?

Can osteosarcomas grow on the knee? In fact, the locations where osteosarcomas commonly appear are indeed near the knee. There are mainly three common sites: the most prevalent is the distal end of the femur, the lower part of the thigh bone. The second most common site is the proximal end of the tibia. The third is the proximal end of the humerus. Therefore, osteosarcomas usually do grow near the knee. What are the symptoms of an osteosarcoma? The symptoms of osteosarcoma include, first, localized pain, which is a constant pain that persists, worsens, and does not alleviate, often causing night pain, and many patients do not feel pain during the day, only at night. The second symptom is a localized lump, generally spindle-shaped, with an increased skin temperature over the surface, and even distended veins due to the tumor restricting nearby joint movement. The third symptom is the appearance of cachexia or wasting syndrome throughout the body. The fourth point is that the growth of the osteosarcoma leads to erosion of the bone and eventually pathologic fractures. Thus, the likelihood of osteosarcomas appearing near the knee is very high, and many patients typically come to the hospital because of painful lumps near the knee, and then, after examination, the diagnosis is confirmed.