Condition Lookup
Sub-Category:
Neoplastic Conditions
Number of Conditions: 2
Bone metastases (e.g., from breast or prostate cancer)
Specialty: Orthopedics and Rheumatology
Category: Conditions with Overlap
Sub-category: Neoplastic Conditions
Symptoms:
bone pain (often deep, aching); swelling at the site of metastasis; fractures or bone instability; difficulty moving the affected limb or joint; numbness or weakness if spinal metastases are present; fatigue
Root Cause:
Cancer cells from primary tumors (e.g., breast, prostate) spread to bones, disrupting bone structure and causing pain, fractures, and other complications.
How it's Diagnosed: videos
Imaging (X-rays, CT scans, MRI, bone scans). Biopsy of bone tissue or suspected lesions. Blood tests (e.g., elevated alkaline phosphatase, calcium levels). PET scan to detect metastasis spread.
Treatment:
Treatment of primary cancer (chemotherapy, hormone therapy, radiation therapy). Bisphosphonates (e.g., zoledronic acid) or Denosumab to strengthen bones. Pain management (NSAIDs, opioids). Surgery (e.g., fixation of fractures, joint replacement). Radiation therapy to target metastatic bone lesions. Palliative care if the condition is advanced and not amenable to curative treatment.
Medications:
Bisphosphonates (e.g., Zoledronic acid, Alendronate ) are used to reduce bone pain and prevent fractures by inhibiting bone resorption. Denosumab (a monoclonal antibody) works similarly to bisphosphonates to inhibit bone resorption. Pain medications
Prevalence:
How common the health condition is within a specific population.
Bone metastases occur in approximately 70% of patients with advanced cancer, with the most common primary cancers being breast, prostate, and lung cancers.
Risk Factors:
Factors or behaviors that increase the likelihood of developing the condition.
Having a history of cancer (especially breast, prostate, lung, or kidney cancers). Advanced stage of primary cancer. Older age.
Prognosis:
The expected outcome or course of the condition over time.
Prognosis depends on the extent of metastasis and the type of cancer. Survival can be prolonged with appropriate treatment, but the condition is often associated with a poor overall prognosis in the late stages.
Complications:
Additional problems or conditions that may arise as a result of the original condition.
Pathologic fractures. Spinal cord compression (if metastasis affects the spine). Hypercalcemia of malignancy. Decreased mobility and quality of life.
Paraneoplastic syndromes with rheumatologic manifestations
Specialty: Orthopedics and Rheumatology
Category: Conditions with Overlap
Sub-category: Neoplastic Conditions
Symptoms:
muscle weakness; joint pain and inflammation; myositis (muscle inflammation); arthritis (often asymmetric); raynaud's phenomenon; skin rashes (e.g., dermatomyositis); fever and malaise; neurologic symptoms (e.g., sensory changes or neuropathy)
Root Cause:
Paraneoplastic syndromes occur due to the body’s immune response to a malignancy, where the immune system mistakenly targets normal tissues such as joints, muscles, and skin. These are not caused by direct tumor invasion but by autoimmunity triggered by the cancer.
How it's Diagnosed: videos
Blood tests (e.g., presence of paraneoplastic antibodies, elevated muscle enzymes such as CK for myositis). Imaging to evaluate joints or muscles. Biopsy of affected tissues (muscle biopsy for myositis, skin biopsy for dermatologic manifestations). Cancer screening (e.g., CT scan, MRI, or PET scan for underlying malignancy). Electromyography (EMG) for muscle involvement.
Treatment:
Treating the underlying cancer is crucial, as this may alleviate the paraneoplastic symptoms. Immunosuppressive therapy (e.g., corticosteroids, methotrexate, azathioprine) to control inflammation and autoimmune response. Physical therapy and rehabilitation to address muscle weakness and joint dysfunction. Plasmapheresis or intravenous immunoglobulin (IVIG) for severe cases.
Medications:
Corticosteroids (e.g., prednisone ) are used to suppress inflammation and immune activity. Methotrexate (an immunosuppressive medication) to manage inflammation in conditions like myositis. Azathioprine (another immunosuppressive drug) can be used for severe cases. IVIG (Intravenous Immunoglobulin), used in refractory cases to modulate immune response.
Prevalence:
How common the health condition is within a specific population.
Paraneoplastic syndromes are relatively rare, with an incidence of around 1-5% of cancer patients. Rheumatologic manifestations are less common but seen in cancers like lung cancer, breast cancer, and hematologic malignancies.
Risk Factors:
Factors or behaviors that increase the likelihood of developing the condition.
Presence of underlying malignancy, particularly small cell lung cancer, breast cancer, or lymphomas. Genetic predisposition to autoimmune diseases. Advanced cancer stage.
Prognosis:
The expected outcome or course of the condition over time.
Prognosis is highly dependent on the underlying malignancy. Paraneoplastic syndromes can sometimes improve with successful cancer treatment, but they may persist or worsen if the cancer progresses.
Complications:
Additional problems or conditions that may arise as a result of the original condition.
Permanent muscle or joint damage if not treated early. Neurological complications (e.g., peripheral neuropathy or myopathy). Decreased quality of life due to pain and disability.