When it comes to diagnosing bone-related health issues, the complexities of medical symptoms can sometimes lead to misunderstandings. Two such conditions that might be confused due to overlapping symptoms are sarcoma and osteoporosis. Understanding the key differences between these conditions is crucial for accurate diagnosis and treatment. To differentiate between the two, the Onlymyhealth team spoke to Dr Nishil Gowda, Consultant, Department of Medical Oncology, Ramaiah Memorial Hospital.
Main Differences Between Sarcoma And Osteoporosis
“Sarcoma is a cancer that develops in the bones and soft tissues, including muscles, fat, nerves, and blood vessels. Sarcoma's major symptoms frequently involve a visible bulge or swelling that may be mild at first but might worsen over time,” said Dr Gowda.
He explained that as the tumour grows, it may cause discomfort, particularly if it compresses nearby nerves or tissues. Other symptoms may include weariness, unexplained weight loss, and, in certain cases, fractures, especially if the tumour affects the bone. “Sarcomas can be difficult to detect since they are rare and have symptoms that are similar to other illnesses,” he said. One such illness is osteoporosis.
Osteoporosis, unlike sarcoma, is a non-cancerous disorder with no tumours. According to the National Institute of Arthritis and Musculoskeletal and Skin Disease, osteoporosis is a disorder marked by a decrease in bone density and strength, leaving bones weak and more prone to fracture. “Osteoporosis symptoms are frequently modest and may not be seen until a bone fracture with little stress, such as a tumble or a sneeze. Common fracture sites include the hip, spine, and wrist,” said Dr Gowda.
Other symptoms may include loss of height over time, a stooped posture, and back discomfort caused by spinal compression fractures. It is often detected with bone density scans and is frequently treated with drugs, calcium, vitamin D supplements, and lifestyle modifications to increase bone strength.
Confusion Between Sarcoma And Osteoporosis
Sarcoma and osteoporosis have independent origins and symptoms, cleared Dr Gowda, “However, certain overlapping symptoms may cause misunderstanding during first examinations.”
Both osteoporosis and sarcoma can cause bone pain and fractures. This is because Osteoporosis causes bone density loss, which renders bones weak and prone to fracture. In bone sarcomas, there might be a risk of fractures due to the weakening of the bone at the tumour site.
Dr Gowda said, “Misdiagnosis can occur if early signs of sarcoma, such as bone destruction or periosteal reactions on X-rays, are misinterpreted as osteoporotic changes. This can delay appropriate investigation and treatment, impacting patient outcomes significantly.”
The key differences between the two are, “Osteoporosis does not usually result in localised swelling or mass development. Sarcomas, on the other hand, often present with symptoms such as a palpable mass or swelling at the tumour site. Depending on the location and size of the tumour, they may also cause pain and restrict movement. However, the existence of a palpable mass or swelling, which indicates sarcoma, is the most differentiating sign,” he said.
Misdiagnosing Sarcoma For Osteoporosis
Dr Gowda confirmed, “While the two illnesses are separate, identification can be difficult, especially when sarcoma causes bone pain or changes in bone density are seen on imaging investigations.”
He explained that clinical knowledge, along with imaging methods such as MRI and biopsy, is critical in differentiating between sarcoma and osteoporosis. MRI detects soft tissue involvement and any related bone abnormalities, whereas biopsy verifies the presence of malignant cells. Osteoporosis is diagnosed using bone mineral density testing and clinical risk factors.
“Imaging examinations such as X-rays, CT scans, and MRI scans are essential for differentiating between the two illnesses. Furthermore, a biopsy is frequently required to conclusively diagnose sarcoma by analysing tissue under a microscope,” he said.
Also Read: Bone Sarcoma: What You Need To Know About This Cancer
A word of advice for healthcare professionals, “To reduce diagnostic mistakes, healthcare professionals must retain a high level of suspicion for sarcoma in patients with unusual or increasing bone pain, especially if the symptoms are disproportionate to the predicted osteoporosis findings,” said Dr Gowda.
He also advised, “To accurately diagnose sarcoma or osteoporosis, patients and healthcare professionals must work together methodically. It is important to be aware of the discerning symptoms of both diseases so patients can immediately report these symptoms to their healthcare practitioner, along with a comprehensive medical history.”
“Patients should also report any previous fractures, a family history of osteoporosis, and lifestyle risks such as smoking and insufficient calcium intake.”
Dr Gowda summed up that sarcoma is characterised by malignant tumours of the bones and soft tissues, whereas osteoporosis is a metabolic bone disease that causes reduced bone density and an increased risk of fracture. Patients and physicians can improve results in the diagnosis and management of both sarcoma and osteoporosis by encouraging open communication and properly utilising diagnostic tools.