Pain is a constant feature often present several months, occasionally years. Swelling, tenderness and warmth in local area. No fever, no weight loss. Neurologic symptoms if tumour in spinal column. Enlarged regional lymph nodes, distant lymph nodes, spleen, liver and other bony sites should be examined.
Findings vary so much that none are considered characteristic.
Infiltrative , permeative, poorly defined interface with normal bone. Often large, obvious soft-tissue extension. Periosteal new bone formation uncommon. Sclerosis may preceed diagnosis by several years and in flat bones may resemble Paget's. When confined to marrow cavity, plain x-ray negative but bone scan and MRI positive.