Knee tumours--duration and nature of symptoms prior to investigation

The incidence of most musculoskeletal neoplasms is highest around the knee. Royal College of Radiologists Guidelines for diagnostic imaging state that plain radiographs are not routinely indicated for knee pain without restriction of movement or symptoms of locking. The notes of 19 patients with knee tumours presenting over a 5 year period were analysed. Irrespective of age or the grade of malignancy the majority of patients had symptoms for around 6 months prior to the initial radiograph. Only four patients had symptoms which would have merited radiological investigation under the present Guidelines. Even in these patients the symptoms prior to either pathological fracture or locking would not have come under the Guidelines. There is a case for regarding persistent, unilateral knee pain for longer than 6 weeks as an indication for imaging.