The unknown

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my 12yo son has had severe ongoing knee pain and was originally diagnosed with osgood shlatters and sent home.

Ended up in a&e with severe pain, throwing up and couldn’t weight bare. They said it was growing pains and once again, sent him home.

He wakes at night in pain, cannot weight bare, night sweats with no fever, weight loss, sickness/nausea and diarreah.

Eventually had X-rays and they showed fragmentation of his tibial bone and he has a huge lump, typical of osgood shlatters, until a orthopaedic surgeon seen him and said the blood results and other symptoms do NOT match osgood shlatters and the “lump” felt different.

She was great and thorough and sent him for urgent blood tests -

ALP raised at 915!

LDH raised for his age at 250.

Everything else came back normal but she was not happy and wanted to rule out a tumour or anything more sinister.

I am terrified.

can anyone shine a light on what any of these blood results mean and what the link is to his symptoms!

thank you, love to all xoxox

Annerose-Macmillan 4 months ago

Dear Ozzy141091de64a,

Thank you for getting in touch with us, and welcome to our online community. My name is Annerose I’m one of the Cancer Information Nurses here at the Macmillan Cancer Support line.

I am sorry to read about your son, and what he has been through. I can imagine how worrying this must be for you.

I hope your son has received some support from the hospital team, and he will feel some relieve of his symptoms.

It is natural that you worry about what the orthopaedic surgeon has said. Unfortunately, we cannot access NHS notes or test results here at Macmillan. This means that we are unable to predict the meaning of the findings.

LDH levels are often nonspecific, and cannot be pinpointed to an exact cause, but they can be indicative of tissue damage, which could be from the tibia fragmentation your son was diagnosed with.

ALP levels in children are normally higher than in adults, this is due to the increased bone activity, and depending on the laboratory, the results can vary slightly. These results can also be higher from an infection affecting the bones for example.

However, considering your sons experience and ongoing symptoms, it would be best practice to continue with further tests.

These might be scans or maybe a biopsy of the lump you mentioned if it is accessible, just to rule out and to find out what the underlying cause of it could be, so they can offer treatment with the best possible outcome.

Have a look at our tips for talking with the healthcare team and use this to best prepare you for the next consultation.

It is important that you are able to express your concerns and get support. Uncertainty can be difficult, and it might be helpful to have an outlet. You might find it helpful to speak directly to one of us nurses via our support line. We are available 7 days a week from 8am to 8pm on 0808 808 0000.

I hope this has been helpful, please don’t hesitate to get back in touch if you need any further information or support.

Best wishes and take care

Annerose (Cancer Information Nurse Specialist)

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.

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The unknown