Diagnosing Musculoskeletal Tumors

Tests and procedures used to detect and diagnose musculoskeletal tumors include:

• Physical exam and history 
• Blood test The doctor may suggest a blood test to determine the level of an enzyme called alkaline phosphatase. A large amount of alkaline phosphatase can be found in the blood when the cells that form bone tissue are very active — when children are growing, when a broken bone is mending, or when disease or a tumor causes production of abnormal bone tissue. Because high levels of this enzyme can normally be found in growing children and adolescents, this test is not a completely reliable indicator of bone cancer.
• X-ray An X-ray can show the location, size and shape of a bone tumor. If X-rays suggest that a tumor may be cancer, the doctor may recommend special imaging tests such as a bone scan, a CT (or CAT) scan, an MRI, or an angiogram.
• CT or CAT (computerized axial tomography) scan A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed prior to the scan to help the organs or tissues show up more clearly. This procedure is also called computed tomography or computerized tomography. A spiral or helical CT scan makes a series of very detailed pictures of areas inside the body using an X-ray machine that scans the body in a spiral path.
• MRI (Magnetic Resonance Imaging) MRI uses a magnet, radio waves and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging.
• Biopsy 
  • The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. A physician may perform a needle biopsy or a small incisional biopsy to check for bone cancer.  During a needle biopsy, a small hole is made in the bone and a sample of tissue is removed from the tumor with a needle-like instrument. In an incisional biopsy, a physician cuts into the tumor and removes a small sample of tissue.
  • Bone scan This procedure allows us to see if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.