Patient selection: pediatric patient
Orthopedic findings that may be red flags for an occult neoplasm:
(1) bone or joint pain that awakens the patient at night that do not meet criteria for growing pains
(2) bone or joint pain that lasts more than 2 weeks
(3) unexplained limp or refusal to walk that lasts more than 2 weeks
(4) bone or joint pain that is localized and not explained by trauma
(5) bone or joint pain that is associated with swelling and not explained by trauma
(6) bone, joint or back pain not relieved by NSAID analgesics
(7) back pain of sudden onset or not explained by trauma
(8) unexplained back pain that persists in a child less than 4 years old
(9) back pain that is worse at night
(10) back pain accompanied by fever or neurologic findings
(11) unexplained kyphoscoliosis or lordosis
(12) unexplained torticollis
where:
• In item 1 the "that do not meet criteria for growing pains" was added.
• In item 8 the originally wording was back pain at age < 4 years.
