Introduction: The aim of this study is to help chiropractors and other healthcare professionals recognize the signs and symptoms that can lead to the identification of a malignant condition like an osteosarcoma, especially in cases where atypical pain presents in pediatric patients.
Clinical features: A 13-year-old boy presented with severe knee pain resulting in the inability to bear weight. There were no obvious causes for the pain that had first developed 24 hours prior to the patient’s visit to the chiropractor. Treatment primarily consisted of administering an x-ray that lead to the discovery of a malignant tumor on the right proximal tibia.
Interventions and outcomes: The patient was sent to a pediatric hospital for further investigation which resulted in a diagnosis of primary metastatic osteosarcoma. Treatment consisted of total resection of the tumor, prosthetic reconstruction, and chemotherapy to eradicate the cancer. The patient is not yet in remission; however, there is no visible trace of malignancy.
Conclusion: Pediatric malignant tumors are typically very aggressive; therefore, early detection of clinical presentations and timely intervention are crucial to improve the outcomes in pediatric patients with primary metastatic osteosarcoma. This particular patient was seen at the right time and a later diagnosis would have likely impacted his prognosis. This case report provides a good example of when to refer a patient. Articular manipulation in this case would have harmed the patient.
Author keywords: case report, osteosarcoma, pediatric cancer, osteogenic sarcoma, pediatric tumor
Author affiliation: Private practice, Chiropratique Mont-Tremblant, Quebec, Canada
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