title: [A boy with a painful knee: bone tumour or stress fracture?].
abstract: BACKGROUND
  The symptoms of a stress fracture are almost identical to those of most bone tumours. Even with the use of various imaging techniques, it can be difficult to establish the correct diagnosis. Although a primary bone tumour requires early treatment to improve its prognosis, the discriminative factor in the diagnosis of a stress fracture is its clinical development over time.
  
  
  METHODS
  A 10-year-old boy was referred to our outpatient clinic on the suspicion of a primary bone tumour in his right tibia.
  
  
  CONCLUSIONS
  A case was once described in this journal in which a stress fracture had eventually led to an amputation. The suspicion of primary bone tumour often marks the start of a long and intense diagnostic course. A stress fracture is the major diagnostic pitfall when there is a suspicion of such a tumour. If doubts persist after a diagnostic work-up by imaging, consultation with the Bone Tumour Committee is indicated. The patient can also be quickly referred to a centre specialised in treating bone tumours, as was the case in this article.
authors.affiliation: Orthopedisch Centrum Oost Nederland, afd. Orthopedie, Hengelo, the Netherlands. bjrobben@gmail.com
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Robben
authors.forename: Paul C
authors.initials: PC
authors.lastname: Jutte
mesh_terms: D000671:Amputation, Surgical; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000601:surgery; D002370:Casts, Surgical; D002648:Child; D003937:Diagnosis, Differential; D015775:Fractures, Stress / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D013977:Tibia / Q000473:pathology* / Q000601:surgery*