Bone Mets Flashcards Preview

Oncology > Bone Mets > Flashcards

Flashcards in Bone Mets Deck (14):
1

Red flags for back pain

Loss of power in limbs (difficulty walking)
Loss of sensation in limbs and perineum
Lack of bladder or bowel control (including urinary retention)

2

Red flags for back pain in PMH

Previous Hx of malignancy

3

Epidemiological red flags for back pain

New onset back pain in children or older adults (>50)

4

Important question to assess nature of back pain

Is it worse at rest?

If so, red flag.

5

Back pain in what area is a red flag?

Thoracic back pain is red flag

6

Differentials for back pain

Cauda equina

Cord compression (trauma, compression fracture, disk herniation, spinal tumour / met, infection)

Osteoporosis

Bone metastases

Mechanical back pain

7

How do you investigate red flagged back pain?

ESR, CRP
FBC, U&Es
Ca2+

Plain X-ray
MRI

Myeloma screen

8

What is metastatic spinal cord compression?

Compression of the spinal cord and/or cauda equina due to a metastatic cancer near the spinal cord.

9

Symptoms of spinal cord compression:

Back pain

Numbness
Parasthesias

Weakness / paralysis

Bladder or bowel dysfunction

10

Examination findings in cord compression

Increase in tone
Loss of power
Hyper-reflexia (especially associated with malignancy)
Loss of sensation (pinprick, temperature, vibration, position)

Loss of tone (spinal shock)

11

Investigations for suspected cord compression

Spine X-ray
MRI spine
CT-guided biopsy and histopathology

12

Differentials for cord compression

Transverse myelitis
GBS
ALS
MS
Diabetic neuropathy

13

Treatment for malignant spinal cord compression

Corticosteroids (relieve pain, reduce oedema)
Surgery
Radiotherapy

14

Blood tests for suspected cord compression

FBC
U&E
LFTs
Bone profile