Dr. Allan Horowitz, published newspaper article, The Liberal, Copyright July 17, 1991

Dear Dr. Horowitz:

I had a scare a few weeks ago when I was having some hip pain and went to my doctor to have it looked at.

He told me it was probably a pulled muscle and he gave me some pills. The pills didn’t help so I went back to him and he sent me for an x-ray. The x-ray showed a “spot’’ in my hip which the doctor became very worried about. He took blood tests and sent me for a bone scan. All he told me was that I had a suspicious looking “spot” in my hip that had to be investigated.

My mind went into overdrive and I was already thinking about whether or not I had been a good enough person to go to heaven. Those few days waiting for the bone scan were pure hell (which is probably where I would end up anyway).

The blood tests came back okay and the bone scan showed I had something called a “bone island.” The doctor told me they were very common and absolutely nothing to worry about.

I was still in shock for a few days, and obviously very relieved, but I am now starting to wonder about what a “bone island” really is. Have you heard of this?

P.S. My hip pain went away completely before I even went for the bone scan.

ANSWER:

Many people think that Bone Island is a new spin-off T.V. show from the producers of Gilligan’s Island, about a group of crazy chiropractors who get stranded on an island.

A bone island is actually a benign type of bone tumor which has no clinical significance at all.

It will not kill you, and it will not even cause you any pain. (Your pain was probably coming from a pulled muscle all along.)

Bone islands look like small, round spots on an x-ray.

As we all remember from St. Elsewhere, and some of us remember from Marcus Welby, a “spot” on an x-ray can sometimes mean that you must check your life insurance policies to make sure everything is in order.

However, sometimes a spot on an x-ray has a happy ending, and there is no happier ending in medicine than finding out your tumor is only a bone island.

No one really know where these things come from, or why, and although there was some question about whether or not they can really grow in size, it is now accepted that they can get a bit bigger with time.

VERY COMMON

They are very common lesions, and can be found in any bone except the skull. They are most common around the hip area.

There are many things which can give the appearance of a simple bone island on an x-ray, and that is why your doctor got a bit worried. He can’t say: ‘’I think you have a tumor. Now we just have to find out what type’’.

But he also can’t say: “Nothing showed by on the x-ray and I want you to go for a bone scan and have blood taken”. Any normal person would get a bit suspicious.

A bone scan shows if there is any increased vascularity, which means there is an abnormal amount of blood flowing into that area. This occurs with many types of bone tumors, but not with a bone island.

One of the most common bone conditions which may be confused with a bone island is a metastatic spread of a cancerous lesion elsewhere in the body. If a person has had previous cancer and now has hip pain and a suspicious looking spot on an x- ray, a bone scan will tell if it is a spread of the previous cancer or if it is “just” a bone island.

TESTS NORMAL

The fact that your blood tests are normal and your bone scan didn’t show any increased blood flowing into the area means that you have a simple, insignificant bone island.

I’ve got an idea for a new television series. The Skipper finally finds a way off the island. The professor builds a pedal-boat. Thurston and Mrs. Howell finance the project. Mary-Ann and Ginger sit around looking cute. Gilligan is in charge of pedalling the boat, but all of a sudden … hip pain. Is it a pulled muscle? Is it a serious bone tumor? Or is it just a “bone island”!