Incidence, location, and diagnostic evaluation of metastatic bone disease

Metastatic carcinoma is the most common malignancy of bone. The clinical pr esentation of patients with skeletal metastasis is variable. When asked to evaluate a patient with a pathologic lesion or unexplained bone pain, the o rthopedic surgeon should follow a logical sequence of steps in evaluating t he patient with suspected metastasis to optimize care and avoid complicatio ns. In the majority of cases, a systematic approach to the patient with ske letal metastasis leads to the correct diagnosis.