Two weeks ago, Xiao Wu (pseudonym), a 10-year-old boy from Shantou, Guangdong, suddenly had pain in the root of his right thigh, and he could only walk with a limp.
Image source: Zhanku Hailuo
Parents took him to a small clinic. The doctor said that he was injured and gave him physical therapy. But Xiao Wu’s severe pain not only did not improve, but continued to worsen.
After another week, poor Xiao Wu was completely unable to stand up, let alone walk.
Mum and Dad were in a hurry, and immediately took the child to a large local hospital to see a doctor. The X-ray showed that the right femur was fractured. You can go to the local hospital and get only one answer: The condition is complicated and cannot be handled.
The cause of the pain is found, but it cannot be cured…
Looking at their son who was in pain every day and couldn’t sleep all night, Xiao Wu’s parents were very anxious, but they didn’t know what to do.
Introduced by someone, they decided to bring their children to Guangzhou to seek medical treatment and experienced ups and downs.
The receiving doctor carefully watched Xiao Wu’s film, combined medical history and physical examination, and found the root cause of the problem-
The child had a tumor on his right femur. The tumor destroyed the bone and caused the fracture.
(The left image is CT image, the red circle is the fracture; the right image is MRI image, the red circle is bone tumor. Photo courtesy of Southern Medical University Hospital of Integrated Traditional Chinese and Western Medicine)
Bone tumor!
Hearing these three words, Xiaowu’s parents were stunned…
“Are our children still alive?”
“Don’t worry, whether the tumor is malignant or benign cannot be determined for the time being. It needs to be cut out for pathological examination. However, the preliminary judgment is that it should be benign.”
The doctor said that Xiao Wu was only 10 years old, and it was the critical period of growth and development. The bone tumor grew on the femur. If it was removed by traditional surgery, it might affect the growth and development of the femur in the later stage. It may affect Xiao Wu’s height.
However, due to the high possibility of benign lesions, minimally invasive surgery can be used to open a “small window” on the outside of the femur to cure the tumor, and at the same time, the fracture of the femur can be treated. Reset and fix. This will reduce the risk of surgery.
Fortunately, the pathological result after Xiao Wushu was benign, and the final diagnosis was aneurysmal bone cyst.
At present, he is recovering well, the wound is healing well, he can stand beside the bed under the protection of the brace, and now he is gradually trying to walk.
(After the bone tumor in Xiaowu’s hip was removed, an internal fixation device was implanted. Photo courtesy of Southern Medical University Hospital of Integrated Traditional Chinese and Western Medicine)
Wait a while to review the X-ray. If the doctor can see that the new bone is slowly filling the bone cavity, Xiao Wu can remove the brace and start daily activities. Walking around the bed, going out for a walk, etc., is no problem.
Image source: Zhanku Hailuo
After the bone graft and the fracture are completely healed, his right leg can basically resume normal activities, running, jumping, ball games, etc. are not affected, and his physical development and growth are also no problem.
Of course!
Bone tumors aren’t as intimidating as you might think.
Xiao Wude’s aneurysmal bone cyst, a benign lesion, accounts for 1.3% of primary bone tumors[1]. It can occur alone or in other bone tumors, but not with malignant tumors.
The disease most commonly occurs in children and adolescents between the ages of 10 and 20, and is very rare after the age of 30. It most commonly occurs at the head end of long tubular bones, the spine, and the pelvis [2].
What is a long tubular bone?
It’s actually the long bones like the “femur” (femur) and “calf” (the tibia and fibula of the lower leg).
Aneurysmal bone cyst is relatively “lazy”, develops relatively slowly, and the symptoms are not too obvious. The main manifestation is a small mass that grows on the body. Slowly it can lead to joint inflexibility.
The pathological fractures like Xiao Wu’s are relatively rare in clinical practice.
Those who read popular science often know that many diseases have similar manifestations and are easily misdiagnosed.
Aneurysmal bone cysts sometimes cause skin redness, vasodilation, and elevated skin temperature, which can easily be misdiagnosed as malignant tumors.
But what’s even scarier is that it behaves a bit like the normal “growing pains” that children have when they are growing up.
Children under the age of 13 sometimes experience cramping muscle pain in the legs, usually in the afternoon or at night, and can even wake the child up in the middle of the night. Growing pains generally begin at the age of 3 to 4 years and tend to recur between the ages of 8 and 12 years [3].
(Schematic diagram of growing pains. Self-made in medical code)
What is the difference between growing pains and bone tumors?
One of the easiest ways to do this is: See if your child is uncomfortable in one leg or hurts in both.
Growing pains usually occur in the legs, especially in the front of the thigh, the back of the calf, or the back of the knee.
If only one leg is in pain, it may be a sign of a more serious condition.
Of course, if the task of judging the disease is given to parents, it is too difficult. If your child keeps complaining about leg pain, take it to the doctor.
If the doctor judges it to be growing pains, no special treatment is usually needed. Parents can massage, stretch, and heat their legs more for their children, and they can also provide calcium supplements to their children.
Reviewer: Xu Hongzhang| Deputy Chief Physician, Department of Orthopedics, Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University
Edited:
Not all bone tumors are curable
Xiao Wu is fortunate that his bone tumor is benign and can be cured.
But there is also a horrific class of bone tumors that afflict not only children but entire families.
In November 2019, Song Xinxin from Qinzhou, Guangxi, had a sudden pain in her feet during physical education class. She sought medical treatment in a local small hospital for many times but did not improve. Xinxin’s leg pain was initially thought to be inflammation, and the local doctor’s treatment plan was also relieved by anti-inflammatory injections. However, after more than a month without improvement, Xinxin’s mother Yi Dengjiao (A Jiao) began to bury a doubt in her heart.
A Jiao’s cousin suffered from osteosarcoma half a year ago. A Jiao told the doctor about this concern, and she also performed enhanced CT and MRI for Xinxin at that time. When the results showed no signs of cancer, I was relieved.
But Xinxin was in pain every time she took physical education class, and when even anti-inflammatory needles could not relieve them, they went to Guangxi Cancer Hospital for a biopsy, and the result showed that the osteosarcoma was advanced. And this diagnosis has been four months since the first pain time, missing the golden period of treatment.
(Xinxin who came to Guangzhou for treatment)
A Jiao felt like the sky was falling when she saw the result. Her daughter, who had rarely even caught a cold since childhood, was suddenly told by the doctor that she had a terminal illness, and she couldn’t accept it for a while. She began to follow her mother to Guangzhou Sun Yat-Sen University Cancer Hospital for treatment. Be strong to fight this war. In addition to appearing in the bones, cancer cells also metastasize to the lungs. The doctor informed Gillian that her daughter’s condition was serious, and Xinxin would need amputation to relieve her condition in the future and to gain a glimmer of hope.
On the other hand, Xinxin was very optimistic. Gillian saw her daughter’s chat record with her friend. She said to her friend, “Just cut it. It’s good to be alive.” This kind of strong The desire to survive moved Gillian so much that she decided to accompany her daughter to win this battle. Xinxin has undergone six chemotherapy treatments, and each time her condition is getting better. She also faces future amputations and lung surgery.
Mother Gillian said: “We have a 0.01% chance to survive, and to have a healthy body is an extravagant hope for us. ”
(Everyone held a birthday party for Xinxin)
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