Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a progressive, deep-seated ache in the proximal tibia, exacerbated by activity and nocturnal rest. Symptoms include localized swelling, palpable bony prominence, and restricted range of motion at the knee joint. No history of recent trauma. Systemic symptoms include unexplained weight loss and fatigue.
Clinical Examination Findings
Physical examination reveals a firm, non-mobile, tender mass over the proximal tibia. Overlying skin shows increased vascularity and localized warmth. Knee joint demonstrates decreased flexion/extension secondary to mass effect. Neurovascular status is intact distally. Regional lymphadenopathy is absent.
Treatment Protocol
Multidisciplinary management plan initiated: Neoadjuvant chemotherapy to achieve tumor shrinkage, followed by limb-salvage surgery (wide resection and endoprosthetic reconstruction) or amputation based on neurovascular involvement. Adjuvant chemotherapy to follow. Regular surveillance imaging (MRI/CT/PET) and pulmonary monitoring for metastatic disease.