Strategy for identifying primary malignancies with inaugural bone metastases.

The diagnosis of primary tumors with inaugural bone metastases is a serious and difficult problem commonly encountered in rheumatology. Helpful information can be derived from the radiologic appearance of the metastases, history of the patient, clinical findings, chest film, standard laboratory tests, imaging studies, serum marker assays, and histologic findings. Based on our personal experience and on previously published data, we have developed a decision tree aimed at enhancing the efficacy of the diagnostic process while ensuring optimal patient comfort and containing costs.

[An unrecognized cause of spinal pain : meningoradiculitis. Apropos of 3 cases with predominant spinal pain]. / Une cause méconnue de rachialgies : les méningo-radiculites. A propos de trois cas à prédominance rachialgique.

Meningoradiculitis can present as a very short episode of radicular pain in addition to vertebral column pain without stiffness, as described in these three cases. The diagnosis requires examination of the cerebrospinal fluid, which should be a routine part of the diagnostic work up for back pain when an inflammatory etiology can not be identified.