Ewing sarcoma is the second most common primary bone malignancy in children and adolescents, requiring urgent multimodal treatment. This in-depth orthopaedic masterclass covers everything from the diagnostic EWS-FLI1 translocation to complex surgical decision-making and the VDC-IE chemotherapy protocol. ⏱ Chapters 0:00 Intro 0:17 Essentials 0:45 Ewing Mnemonic 1:17 Pathophysiology 1:59 Imaging Signs 2:34 Enneking Staging 3:05 Management 3:53 Chemo Mnemonic 4:26 Prognosis Numbers 4:55 Clinical reasoning — Mimic 5:25 Clinical reasoning — Margins This video provides a comprehensive deep dive into Ewing sarcoma, a highly malignant small round cell tumour. We explore the underlying molecular biology, including the t(11;22) translocationand review classic radiographic findings such as onion-skin periosteal reactions. The masterclass breaks down the Enneking staging system, details the VDC-IE neoadjuvant chemotherapy regimenand outlines the critical principles of wide surgical excision and limb salvage. Whether you are learning about musculoskeletal oncology for the first time or consolidating your clinical knowledge, this video explains why early recognition and strict multimodal management are vital for improving patient survival. 🦴 IN THIS VIDEO YOU'LL LEARN • How to identify the clinical presentation of Ewing sarcoma and why it frequently mimics osteomyelitis • The molecular significance of the t(11;22) EWS-FLI1 translocation and its role as a diagnostic hallmark • Recognising classic radiographic features like permeative lytic destruction, onion-skin periosteal reactionand Codman triangle • Interpreting histological findings including small round blue cells, glycogen-rich PAS positive stainingand diffuse CD99 membrane positivity • Applying the Enneking surgical staging system to stratify localised versus metastatic bone tumours • Understanding the five-agent VDC-IE chemotherapy protocol and its specific drug toxicities • The critical importance of neoadjuvant chemotherapy before achieving local control with wide surgical excision • How tumour necrosis percentage, tumour volumeand metastatic status dictate patient prognosis and survival rates • The role of radiation therapy at 55.8 Gray for unresectable pelvic tumours and positive surgical margins ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Ewing sarcoma classically presents in the diaphysis of long bones in patients aged 10-20 years old. ✔️ Fever and elevated inflammatory markers can mimic infection, making tissue biopsy essential for diagnosis. ✔️ The EWS-FLI1 fusion oncogene from the t(11;22) translocation is the diagnostic gold standard. ✔️ Treatment strictly follows a multimodal paradigm: neoadjuvant chemotherapy followed by wide surgical excision. ✔️ Operating before administering chemotherapy is a critical error that significantly worsens patient survival. ✔️ Over 90% tumour necrosis post-chemotherapy predicts a better prognosis, while metastatic disease drops survival to 30%. 👩⚕️ WHO THIS IS FOR This masterclass is designed for orthopaedic trainees, junior doctorsand medical students seeking a comprehensive understanding of bone malignancies. It is also highly relevant for practising clinicians and curious patients wanting to understand the complex surgical and oncological management of Ewing sarcoma. 📚 RELATED TOPICS: Osteosarcoma diagnosis and surgical management · Small round blue cell tumours of bone · Enneking surgical staging system for musculoskeletal tumours · Limb salvage surgery in paediatric orthopaedics · Neoadjuvant and adjuvant chemotherapy protocols in sarcoma · Onion-skin and sunburst periosteal reactions 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #ewingsarcoma #bonetumour #orthopaedicsurgery #orthopedics #pediatriconcology #musculoskeletaloncology #pathology #osteosarcoma #surgeoneducation #medicalstudent #orthoteaching #saratoma