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Epiphyseal lytic lesions
- Geode (OA, CPPD, RA, AVN)
- Intraosseous ganglion
- Giant Cell Tumor
- Chondroblastoma
- Clear cell chondrosarcoma
- EG
- Infection (Brodie's abscess)
- Brown Tumor
- Subchondral cyst
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Aggressive diaphyseal lesion in young patient?
Ewing sarcoma
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Metaphyseal MSK lesions?
- Sarcomas:
- - chondro
- - osteo
- - fibro
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Multiple lytic lesions
"FEEMHI"
- Fibrous dysplasia
- EG
- Enchondroma
- Mets, Multiple Myeloma
- Hyperparathyroidism
- Infection
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Blastic bony lesions?
- Bone island
- Mets
- - prostate
- - breast
- - GU
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What is osteopoikilosis?
- Multiple bone islands
- Ephiphyses and metaphyses
- Sometimes difficult to differentiate from mets
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Lytic lesions in posterior elements?
GO APE
- GCT
- Osteoblastoma
- ABC
- Plasmocytoma
- EG
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Where do osteosarcoma mets go?
- Lungs
- Other bones
- - look for skip lesions
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What are risk factors for secondary osteosarcoma?
- Age >60
- Occurs 5% of cases
- - Pagets
- - XRT
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What are the chondroid tumors?
- BENIGN
- - enchondroma
- - chondroblastoma
- - osteochondroma
- MALIGNANT
- - chondrosarcoma
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DDx for fluid-fluid levels in the bones?
- ABC
- Chondroblastoma
- Osteoblastoma
- GCT
- Telangectatic osteosarcoma
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Features of a LCH?
- Geographic lytic lesion
- Non sclerotic margin
- No matrix
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Features of Giant Cell Tumor?
- 1) Skeletally mature
- 2) Eccentric
- 3) Subarticular
- 4) Non sclerotic, narrow zone of transition
Knee (65%) , Wrist (15%) , Pelvis (15%)
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Features of a chordoma
- - low grade malignancy which arises from notochord remnants
- - locally aggressive with a soft tissue component
- - sacrum > clivus > vertebral body
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