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Assessing unit perspectives on referrals to a regional bone and soft tissue tumour service
Armitage, Jessica Subudhi, Trisha Rao, Vijesh Ashwood, Neil
Armitage, Jessica
Subudhi, Trisha
Rao, Vijesh
Abstract
Pathologies of bone and soft tissues may be complex and heterogeneous; referral patterns influence service efficiency and workflow. This study quantifies regional evidence of referral volume, diagnostic outcomes, and pre-referral imaging pathways from the perspective of referring units. All referrals to a tertiary United Kingdom Midlands National Health Service (NHS) bone and soft tissue service over a 10-year period were retrospectively assessed using a prospectively maintained institutional database. In total, 279 patients were referred for specialist assessment during the study period. Diagnoses were classified as provisional or final, with imaging modalities categorised as first-, second-, or third-line investigations prior to referral in accordance with the order in which they were performed. True malignant bone tumours, as defined by histology, constituted a small proportion of referrals: seven patients (2.5%). Benign bone and soft tissue lesions represented a sizeable proportion of provisional diagnoses: 81 patients (29.0%). Metastatic disease and malignant bone tumours were provisionally diagnosed, more commonly than they were confirmed by specialist assessment: 84 patients (30.1%) provisionally referred, 35 patients (12.5%) confirmed following specialist review. Referral volumes varied across specialties and many patients underwent multiple imaging studies prior to referral. These findings provide baseline observational data from a single regional service and highlight the role of specialist bone and soft tissue tumour centres as important diagnostic triage and risk-stratification services within a landscape of heterogeneous pathology and referral pathways. The identification of malignant disease within a small subset of referrals reinforces the value of early specialist assessment for patients with suspected bone and soft tissue tumours.
MIDER Authors
Affiliations
University Hospitals of Derby and Burton NHS Foundation Trust; University of Leicester
Date
2026-03-18
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Article
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(14) Cureus.pdf
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Citation
Armitage J, Subudhi T, Rao V, Ashwood N. Assessing Unit Perspectives on Referrals to a Regional Bone and Soft Tissue Tumour Service. Cureus. 2026 Mar 18;18(3):e105438. doi: 10.7759/cureus.105438.
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Armitage et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.