All patients with a suspected/diagnosed bone sarcoma should be referred to a Sarcoma Specialist Centre.

Please note that this diagnostic toolkit is intended for healthcare professionals based in England, Wales and Northern Ireland only. For Scotland’s diagnostic toolkit, click here.

Clinical presentations

Unexplained bone pain or tenderness, which is:

• persistent
• increasing
• non-mechanical
• nocturnal or at rest

Investigations

Adults

• Refer for urgent x-ray (performed within 2 weeks)
• Refer for urgent appointment (within 2 weeks) to a bone sarcoma specialist centre if an x-ray suggests bone sarcoma, or if findings are uncertain and clinical concern remains

Children

• Refer for very urgent x-ray (performed within 48 hours)
• Refer for very urgent appointment (within 48 hours) to a sarcoma specialist centre if an x-ray suggests bone sarcoma, or findings are uncertain and clinical concern remains