Sacral and non-spinal tumors presenting as backache. A retrospective study of 17 patients

Among 1302 cases reported to our tumor registry, 78 presented with backache as primary symptom. 17 of these had non-spinal tumors, 7 pelvic, 6 sacral, 3 femoral, and 1 costal. There were long delays in making the correct diagnosis; some patients even had had spinal surgery. The mistakes were the classic ones: poor history, poor physical examination, poor radiological work-up. Analysis of these 17 cases suggests that standard spinal radiographs should include an AP pelvis film and a lateral sacral projection. Patients with persistent radiating pain and normal radiographs should have a Tc-99 scan. The correct diagnosis would have been made in all the cases if this protocol had been followed.