In approaching the diagnosis of the etiology of apparent skeletal pain in a patient with cancer, the history and physical examination are important but insufficiently sensitive and specific. Skeletal radiography of the painful site is the fastest and least expensive approach, but a whole-body bone scan will provide a complete picture of the extent and severity of the disease. It is important to know the degree of osteolysis in a painful site of bone metastasis, as this will determine which therapeutic modality is employed, as will be detailed next. These two imaging modalities complement each other in important ways in diagnosing and treating the pain of osseous metastases.
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