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Primary posterior lateral tumor S/S
- Disc first compresses sheath then dura mater
- S/S 1st in arm then in neck/shoulder as progress
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Secondary posterior lateral tumor S/S
1st disc compresses dura matter then dura sheath
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S/S disc lesion
- 1. Root pain stabilizes after 2 mo
- 2. coughing hurt in scap
- 3. Unilat symptoms
- 4. non-capsular
- 5. slight weakness if any (bc only compresses 1 NR)
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intramedullary tumor S/S
- 1. slow evolution
- 2. pain in neck, not radicular (bc in SC, cant compress dural sheath)
- 3. local hyperesthesia
- 4. motor/sensory loss at LOL (early)
- 5. cord signs (late)
- 6. no articular signs bc not in foramen
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Metastatic bone tumor S/S
- Adults: more common than primary bone tumors
- Sources: breast, lung, thyroid, kidney, prostate, colon, skin
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Best tests for metastatic bone tumors
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Warning signs of cervical osseous tumors
- 1. gradually increasing pain (especially at night)
- 2. expanding pain
- 3. bilat arm pain
- 4. Muscle spasm or empty PROM
- 5. capsular pattern (bone fx or CA)
- 6. painful/weak neck MMT
- 7. 2-3 NR involved
- 8. BLT KP & CS (metastases)
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Spinal tumor warning signs
- 1. >50
- 2. elderly w/ neck pain for 1st time
- 3. children = primary bone tumor
- 4. PMHx CA
- 5. unexplained weight loss
- 6. constant progressive pain at night
- 7. pain lasting >1 mo
- 8. PT doesn’t help within 1 mo
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____% of bone must be destroyed before a radiograph will be positive
30-50% (MRI and CT better)
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a young adult w/ Osteoblastoma may exhibit ________ instead of the capsular pattern
torticollis (but torticollis normally get better quickly so this pt has CA)
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Pancoast Tumor S/S
- Painful scap elevation and SB away
- Hx smoking
- >50
- Horner’s syndrome
- If large enough will compress brachial plexus causing pins/needles/ weakness in C8-T1
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initial radiograph for Pancoast tumor may be __________, requiring a ____________
false negative, transthoracic needle biopsy
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Horner’s syndrome S/S
- 1. decreased sweating
- 2. ptosis
- 3. miosis pf pupil (constriction)
- 4. enopthalmos (recession of eye ball)
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when looking at lateral imaging what to look for
- 1. disruption in 3 parallel lines (fx or dislocation)
- 2. osteophytes
- 3. intervertebral disc space height
- 4. intervertebral foramina
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