Osteoblastoma: Or something else? Differential Diagnosis

Musculoskeletal system and connective tissue (M00-M99).

  • Aneurysmal bone cyst (AKZ) – tumor-like osteolytic lesions (“bone loss”) with dark red to brownish cavities up to 14 cm3 in size.
  • Fibrous dysplasia – malformation of bone tissue, that is, the bones form tumor-like protrusions; especially the inner nose and paranasal sinuses.

Neoplasms – tumor diseases (C00-D48).

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Growing pains-about one-third of all children between 2 and 12 years of age occasionally suffer from growing pains; they usually occur in the evening or at night (80% of cases); the next morning, the child is able to move without pain and without restrictions
    • Symptoms/complaints:
      • Brief burning, pulling, or throbbing pain in both legs or arms.
      • Can be so painful that children are jolted from sleep
    • Localizations:
      • Front sides of the thighs
      • Backs of knees
      • Shins or calves
      • Pain always occurs on both sides, alternating between both extremities if necessary, and can vary in intensity
      • Joints are not affected
    • Growing pains are pain at rest, not pain on exertion [diagnosis of exclusion! Conditions to clarify include rheumatic diseases, bone tumors, bone infections or unnoticed bone injury]
    • Complaints are self-limiting
    • Warning signs (red flags) of malignancy (malignant tumor): B symptoms (severe night sweats, unexplained persistent or recurrent (recurrent) fever (> 38 °C); unwanted weight loss (> 10% percent of body weight within 6 months)), back pain as the main localization, palpable mass, bleeding tendency, nonarticular bone pain (bone pain that does not involve a joint); abnormalities in the blood count and smear, LDH ↑
    • Physical examination: no abnormal examination results.
    • Laboratory diagnostics:
      • Small blood count
      • Differential blood count
      • ESR (erythrocyte sedimentation rate)
      • If necessary, also determination of transaminases, alkaline phosphatase (AP), LDH, creatinine.
    • Medical Device Diagnostics:
      • X-ray in two planes
      • Magnetic resonance imaging (MRI) of the affected region.

Injuries, poisonings and other consequences of external causes (S00-T98).

  • Injuries/sports injuries