[Diagnostic strategy in primary malignant bone tumors in children]

Our experience concerning the diagnostic proceeding for primary malignant bone tumours in children and their often difficult differentiation from osteomyelitis are discussed. A retrospective evaluation of patient records of 66 children showed, that in 53 cases (41 with osteomyelitis, 12 malign tumours) diagnosis was immediately obtained from clinical and radiological results. For five more children osteomyelitis was proven by short term monitoring and paraclinical investigations, while in 8 cases final diagnosis required biopsy. CT was relevant for the evaluation of intraosseous and intramedullary extending tumours and mandatory for therapy planning. Conventional radiography, however, remains the most important method within the diagnostic strategy, but the need for close cooperation of radiologists and clinicians and a synoptic evaluation of clinical results, radiography and anamnestic data must be stressed.