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multiple lytic lesions in the pelvis with widening of the pubic symphysis
brown tumors of hyperparathyroidism
widened ps = subperiosteal bone resorption
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Must be mentioned in every diff dx for lytic bone lesion if patient is under 30
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Must be mentioned in every differential diagnosis in a lytic lesion with a patient >40 years of age
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Looks like fibrous dysplasia, but in the tibia
Adimantinoma
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benign sclerotic lesion in the femoral neck
fibrous dysplasia
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Descriminators to tell enchodroma from chondrosarcoma
- Chondrosarcoma has -
- pain
- mri soft tissue
- mri scalloping
- Don't ever give differential of enchondroma vs chondrosarcoma,
- don't want to biopsy an enchondroma because it looks like chondrosarcoma
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multiple enchondromas only
Ollier's disease (no risk of malig degen)
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Multiple enchondroma's + hemangioma's
Mafucci's (inc. risk of malig. degen)
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Giant cell discriminators
- epiphysis must be closed
- must abut articular surface
- eccentric
- well defined, but nonsclerotic margin
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Don't touch lesions
- Enchondroma
- Non-ossifying fibroma
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patient under 30, cortically based lytic lesion, sclerotic margin, no pain
NOF
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DDx: Expansile lytic bone lesion with patient under age of 30
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Bone lesions where patients have to be under 30
- •EOSINOPHILIC GRANULOMA
- •ABC
- •NON-OSSIFYING FIBROMA
- •CHONDROBLASTOMA
- •SOLITARY BONE CYST
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Bone lesions with no pain or periostitis
- •+/-FIBROUS DYSPLASIA
- •ENCHONDROMA
- •NON-OSSIFYING FIBROMA
- •SOLITARY BONE CYST
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Epiphyseal lesions
- •CHONDROBLASTOMA
- •INFECTION
- •GIANT CELL TUMOR
- •GEODE (SUBCHONDRAL CYST)
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Multiple lytic lesions
"FEE HIM"
- •FIBROUS DYSPLASIA
- •ENCHONDROMA
- •EOSINOPHILIC GRANULOMA
- •HYPERPARATHYROIDISM
- •INFECTION
- •METS & MYELOMA
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Partial articular surface tear of the supraspinatus near its humeral head insertion
- rim rent tear
- occurs in the "critical zone"
-
DDx: Cortical holes "pseudopermeative appearance"
- –Aggressive osteoporosis
- –Hemangioma
- –Radiation changes
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