Taking a history

Taking a history from a patient with a suspected bone or soft tissue tumour requires a different emphasis from the rest of orthopaedics. Particular features to note include:

  • Length of history (is this a preexisting mass that has changed?)
  • Rate of growth
  • Pain history (site, character, severity, radiation, modifying factors, periodicity – is there mechanical or night pain?)
  • Previous surgery at the site of interest (ie is this a local recurrence?)
  • History of  malignancy (could this be a metastasis?)
  • History of a predisposing condition (eg Hereditary Multiple Exostoses)
  • Previous radiotherapy
  • Family history (think  inherited disorders like Li Fraumeni syndrome)
  • Symptoms suggestive of malignancy (eg weight loss, lethargy)

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