Bone Pain: Clinical Meaning

Leukemia

Leukemia is a cancer of blood-forming tissues that disrupts normal blood cell production. It is classified by speed of progression (acute/chronic) and cell type (lymphocytic/myeloid), causing fatigue, bleeding, and infections.

Multiple Myeloma

Multiple myeloma is a cancer of plasma cells in the bone marrow, causing bone pain, anemia, kidney damage, and recurrent infections. Symptoms arise from the accumulation of abnormal plasma cells.

Bone Cancer (Osteosarcoma)

Osteosarcoma is the most common primary bone cancer, predominantly affecting adolescents. It presents as bone pain and swelling, most often around the knee; treatment involves surgery and chemotherapy.

Osteomyelitis

Osteomyelitis is a bone infection caused by bacteria or fungi, causing localized bone pain, fever, and tenderness. Staphylococcus aureus is the most common causative organism; treatment requires prolonged antibiotics and sometimes surgery.

Hyperparathyroidism

Primary hyperparathyroidism is caused by overactive parathyroid glands producing excess PTH, leading to hypercalcemia, bone loss, kidney stones, and GI symptoms. Most cases are caused by a benign parathyroid adenoma.

Vitamin D Deficiency

Vitamin D deficiency impairs calcium absorption and bone mineralization, causing bone pain, muscle weakness, fatigue, and increased fracture risk. It is extremely common globally due to limited sun exposure and dietary insufficiency.

Paget's Disease of Bone

Paget's disease of bone is a chronic disorder causing excessive bone remodeling, resulting in enlarged, deformed, and structurally weakened bones. Commonly affected areas include the spine, pelvis, skull, and femur; bisphosphonates suppress disease activity.

Hypercalcemia

Hypercalcemia is elevated blood calcium, most commonly caused by overactive parathyroid glands or cancer. Symptoms follow the mnemonic 'bones, stones, groans, and psychic moans'.

Primary Biliary Cholangitis

Primary biliary cholangitis is a chronic autoimmune liver disease causing progressive bile duct destruction. Left untreated it leads to liver cirrhosis.