bone pain
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Introduction
Pain originating from bone. Also see arthralgia.
Etiology
- fracture or trauma (focal)
- infection, osteomyelitis
- osteoid osteoma (focal)
- malignancy (primary or metastatic)
- leukemia
- Paget's disease (focal or diffuse)
- osteomalacia (diffuse, vitamin D deficiency)[2]
- osteoporosis (diffuse)
- ischemia (sickle cell anemia)
- metabolic bone disease (diffuse)
- overuse
Management
- NSAIDs[3][6]
- glucocorticoids[6]
- dexamethasone (up to 24 mg/day in divided doses; 4 mg BID[5])
- useful in patients with renal failure
- lack of data of efficacy of epidural glucocorticoids for metastatic bone pain[5]
- dexamethasone (up to 24 mg/day in divided doses; 4 mg BID[5])
- bisphosphates[6]
- pamidronate
- zoledronate[6]
- literature inconsistent on acute analgesic efficacy of bisphosphonates for bone pain[5]
- opiates
- calcitonin of no benefit[5]
More general terms
Additional terms
References
- ↑ Ferri's Clinical Advisor, Instant Diagnosis and Treatment, Ferri FF (ed), Mosby, Philadelphia, 2003, pg 950
- ↑ 2.0 2.1 Prescriber's Letter 11(2):11 2004 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=200211&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 3.0 3.1 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
- ↑ Choy E, Attar EC, Oh KS, Huang AJ, Kerr DA. Case 33-2014 - A 60-Year-Old Man with Bone Pain. N Engl J Med 2014; 371:1630-1640. October 23, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25337753 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcpc1310000
- ↑ 5.0 5.1 5.2 5.3 5.4 NEJM Knowledge+ Question of the Week. Sept 10, 2019 https://knowledgeplus.nejm.org/question-of-week/1783/
Chow E, Meyer RM, Ding K et al Dexamethasone in the prophylaxis of radiation-induced pain flare after palliative radiotherapy for bone metastases: a double-blind, randomised placebo-controlled, phase 3 trial. Lancet Oncol. 2015 Nov;16(15):1463-1472. Epub 2015 Oct 18. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26489389
von Moos R, Strasser F, Gillessen S, Zaugg K. Metastatic bone pain: treatment options with an emphasis on bisphosphonates. Support18682990 - ↑ 6.0 6.1 6.2 6.3 6.4 Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
- ↑ Bone pain or tenderness Medline Plus http://www.nlm.nih.gov/medlineplus/ency/article/003180.htm