Clinical features
Bone pain Elderly Previous cancer/known primary Fever, wt loss, malaise Chest and bowel red flags Breast lumps -> spine, pelvis, ribs
Common primary’s
Round cell tumours in children Lung Breast Thyroid Renal Lymphoma Leukaemia Prostate
Investigations
FBC-anaemia LFTs Increased Ca Increased CRP and ESR PSA X Ray only if >50% bone loss Isotope gone scan CT/MRI
Management
Analgesia Splint Radiotherapy IV bisphosphonates Inter medullary fixation Nerve decompression