Table 1.

Quality Scoring Criteria

Diagnosis

• Metastatic bone disease as most common in adults

• Discusses difference in benign versus malignant lesions

• Discusses different diagnoses based on age

• Discuses different tools for diagnosis (Radiograph, CT, MRI, bone scan, and biopsy)

Anatomy

• Discusses most common bones affected (distal femur, proximal tibia, and proximal humerus)

• Discusses regions of the bone affected (intramedullary, cortical, metaphyseal, and epiphyseal)

• Sarcomas can be aggressive and extend out of the bone

Treatment

• Treatment may involve chemotherapy

• Treatment may involve radiation therapy

• Treatment may involve surgery

• Treatment may be observation

• Surgery has two main purposes: tumor resection and reconstruction

• Sometimes treatment may be palliative instead of curative

• Patients may need stabilization if at risk for pathologic fracture

• Discusses surgical adjuvants (argon beam, phenol, and liquid nitrogen)

• Surgery may be initially delayed and patient restaged after neoadjuvant therapy

• Discusses limb salvage surgery versus amputation

• Notes treatment is multidisciplinary (medical oncologist, orthopaedic oncologist, radiation oncologist, musculoskeletal radiologist, musculoskeletal pathologist, physical medicine and rehabilitation, and pain specialist)

Complications

• Sarcoma can metastasize to other locations (commonly lungs/other bones)

• Lesions in weight-bearing bones may result in pathologic fractures

• Lesions may recur even if resected

• Patients must be monitored regularly after resection

• Surgery in children may result in growth disturbances/limb length inequality

• Wounds may become infected

• Surgery may require resection of structures such as muscles, vessels, and nerves that limit future function

Score _______/25