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 Scotland only. For England, Wales and Northern Ireland’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
• Refer for urgent appointment to a 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
• Refer for urgent appointment for specialist appointment at a sarcoma specialist centre if an x-ray suggests bone sarcoma, or findings are uncertain and clinical concern remains

Note: Radiographs may be normal in patients with early bone sarcoma.