Primary bone cancers include osteosarcoma, Ewing’s sarcoma, and chondrosarcoma. Osteosarcoma, the most common bone cancer, occurs most often in children and adolescents. It usually develops in the midzone of the long bones, specifically the distal femur, proximal tibia, and proximal humerus.

They represent less than 1% of cancers diagnosed each year, however bone is much more commonly the site of metastasis or spread from other types of cancer and is associated with significant morbidity and mortality.

Timely diagnosis is challenging due to late patient presentation, non-specific symptoms of the malignant tumor, which mimic common musculoskeletal injuries, and low suspicion by clinicians.

Plain radiography is the preferred diagnostic test. Radiographic suspicion of bone cancer should prompt prompt referral to a cancer center for multidisciplinary care.