This radiograph in an adolescent with worsening nocturnal thigh pain should raise concern for osteosarcoma. The characteristic sunburst appearance results from the periosteum forming divergent bone spicules in response to aggressive tumor growth and often is accompanied by other radiographic features, like Codman’s angle or triangle. Although rare, osteosarcoma is the most common malignant bone tumor, with peak incidence during adolescence and occurrence at sites of rapid bone growth (e.g., long-bone metaphyses). Treatment generally involves systemic chemotherapy with surgical resection, which was successful for the patient in this case.
Comment
This radiograph in an adolescent with worsening nocturnal thigh pain should raise concern for osteosarcoma. The characteristic sunburst appearance results from the periosteum forming divergent bone spicules in response to aggressive tumor growth and often is accompanied by other radiographic features, like Codman’s angle or triangle. Although rare, osteosarcoma is the most common malignant bone tumor, with peak incidence during adolescence and occurrence at sites of rapid bone growth (e.g., long-bone metaphyses). Treatment generally involves systemic chemotherapy with surgical resection, which was successful for the patient in this case.