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Bony Tenderness



    • How to Elicit

    • Gently press over each spinous process, asking the patient if this elicits pain.
    • Significance

    • May be an indicator of malignancy.
    • Causes of Bony Tenderness

    • Traumatic fracture
    • Pathologic fracture - osteoporosis, osteomalacia, osteogenesis imperfecta, Paget’s disease of bone
    • Osteolytic lesions - multiple myeloma, bony metastasis, fibrous dysplasia, bone cyst
    • Osteosarcoma
    • Infection - osteomyelitis,  septic arthritis
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