Initial pre-referral workup

Clinical history

• standard history
• physical examination
• standard examination

Investigations

• plain X-ray
• FBE and U&E
• ESR/CRP/LFT

Do not administer needle biopsy or injection. 

GP management

Nil, refer parents to Tumours in children (fact sheet).

Indications for specialist referral

Urgent

• all cases of tumours or suspected tumours should be referred to the RCH musculoskeletal tumour service. The referral should be discussed verbally with the on call staff.