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Ewing Sarcoma: Recognizing Fever and Bone Pain in Children for Rapid Diagnosis

A Hispanic 10-year-old boy sitting on a hospital stretcher, displaying discomfort and holding his leg, while a Hispanic doctor examines his leg, illustrating the importance of recognizing fever and bone pain in the early diagnosis of Ewing sarcoma in children, along with elevated LDH and imaging studies.

Ewing sarcoma is a type of malignant bone tumor that primarily affects children and adolescents. Early detection is crucial for improving clinical outcomes, but it is often delayed due to the nonspecific nature of its initial symptoms. Among the most common signs are persistent bone pain and fever, which can easily be confused with other less serious conditions.

Importance of Early Detection

Timely diagnosis of Ewing sarcoma is essential to initiate appropriate treatment and improve prognosis. A recent study evaluated the interval until diagnosis in pediatric bone sarcomas, finding that the average time from initial presentation to diagnosis was approximately 20 days. However, 20% of patients experienced significant delays, averaging 54 days, particularly those with initial negative X-rays.

Bone pain is the most frequent symptom, present in 89.5% of cases, and may be accompanied by fever and localized swelling. These symptoms, while common, are not specific, underscoring the need for thorough evaluation and the use of advanced imaging studies, such as MRI, for more accurate diagnosis.

Conclusions

Education for both the public and healthcare professionals about the suspicious signs and symptoms of Ewing sarcoma is fundamental to reducing the time to diagnosis. The presence of persistent fever and bone pain in children should be evaluated with a high index of suspicion, considering the possibility of Ewing sarcoma. Additionally, elevated LDH may serve as a useful marker in the appropriate clinical context.

In summary, early detection and multidisciplinary management are key to improving survival and quality of life for pediatric patients with Ewing sarcoma.

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Created 13/1/2025