Critical CBD: Primary and secondary musculo-skeletal malignancy CBD is important as any Consultant, regardless of their subspeciality, who is on a general emergency take-  is likely to come into contact with patients with new or known malignant diagnoses. How we go about investigating and managing those patients has significant effects on their morbidity and mortality, and so it is important at the very least to be aware of the appropriate way to assess these patients and refer on. 

There is a high turnover of advances in Oncological treatment options, it is therefore important to seek the advice of our Oncological colleagues when we consider treatment options, as they have better insight into estimating prognosis . Patients with metastases are surviving longer with their cancers, and with improved survivability we may see further increases in the incidence of metastatic bone disease in our emergency takes. 

While managing a general take, we also need to be able to consider if a lesion may represent a primary bone tumour, and therefore recognise when tertiary level care is required. 

We thank Miss Kate Spacey, a newly appointed consultant at the Norfolk and Norwich University Hospital sub-specialising in revision hip and musculoskeletal oncology