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What are the top 3 benign bone tumors?
- Osteochondroma
- Chondroma
- Osteoma
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What are the big 6 MC malignancies that spread to the skeleton?
- Breast 2o metastasis
- Lung 2o metastasis
- Prostate 2o metastasis
- Kidney 2o metastasis
- Ewing's 1o metastasis
- Neuroblastoma 2o metastasis
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What is the MC malignancy?
Metastasis
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What is the MC 1o malignancy?
- Multiple myeloma
- Osteosarcoma
- Chondrosarcoma
- Ewing's sarcoma
- Fibrosarcoma
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What is the MC 1o malignancy under 30 yo?
Osteosarcoma
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What is the MC 1o malignancy under 10 yo?
Ewing's sarcoma
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What is the MC tumor of the patella?
Giant cell tumor
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What is the MC tumor-like condition?
Fibrous dysplasia
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What is the MC BT of spine?
Hemangioma
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What is the MC BT of sacrum?
Giant cell tumor
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What is the MC BT of hand?
Chondroma/ enchondroma
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What is the MC BT of clavicle?
aneurysmal bone cyst
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What is the MC PMT to metastasize to bone?
Ewing's sarcoma
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What is the MC PMT of clivus?
Chordoma
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What is the MC PMT of C2?
chordoma
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What is the MC PMT of hand?
Chondroma
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What is the MC PMT of chest wall?
Chondrosarcoma
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What is the ONLY PMT w/ sequestration?
Fibrosarcoma
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What are the 3 top Ivory vertebra lesions?
- Blastic metastasis- 50-70 yo, not enlarged
- Hodgkin's lymphoma- 20-40 yo, A scalloping
- Paget's disease- 40-60 yo, enlarged & square
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What are the vertebral body lesions? (MOM LOACH)
- Metastasis- 50-70 yo, blastic or lytic
- Osteoblastoma- 1-50 yo, geographic expansile
- MM- 50-70 yo, punched out
- Lymphoma- 20-40 yo, A scalloping
- Osteoid osteoma- 100-30 yo, nidus
- Aneurysmal bone cyst- 11-30 yo, geographic
- Chordoma- 41-70 yo, lytic w/ soft tissue mass
- Hemangioma- 41-50 yo, alternating striations
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What are the sacrum lesions?
- Chondrosarcoma- 40-60 yo, soap bubble lesion
- Chordoma- 40-70 yo, lytic w/ soft tissue mass
- Giant cell tumor- 20-40 yo, soap bubble
- Metastasis- 50-70 yo, blastic or lytic
- MM- 50-70 yo, punched out
- Paget's disease- 40-60 yo, cortical thickening
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What are the epiphyseal tumors?
- Chondroblastoma- benign tumor
- Giant cell tumor- PQMT (primary quasi malignant tumor)
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What are the diaphyseal tumors?
- Ewing's sarcoma- PMT, 10-25 yo, no pain, moth eaten
- MM- PMT, 50-70 yo, PAIN, punched out
- Non-Hodgkin's lymphoma- PMT, 21-40 yo, no pain, moth eaten w/ mass
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What are the cortical tumors?
- Osteoblastoma- BT, 1-50 yo, femur & spine, pain, geographic expansile
- Osteoid osteoma- BT, 11-30 yo, long bone, spine. PAIN, blastic w/ nidus
- Osteoma- BT, any age, skull, no pain, blastic
- Parosteal osteoma-PMT, 31-50 yo, long bone, PAIN, blastic w/ stalk
- Periosteal osteoma-PMT
- Hemangioma-P vasular BT, 41-50 yo, spine, skull, no pain, alternating striations
- Paget's disease- tumor like- 40-60 yo, skull, spine, pelvis, cortical thickening
- Paget's disease
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What are tumors of the cranial vault?
- Osteoma- BT, blastic
- MM- PMT, punched out
- Chordoma- PVMT, lower skull, lytic w/ soft tissue mass
- Hemangioma- PVBT, alternating striations
- Cholestatoma- TL, in ear canal, geographic
- Paget's disease- TL, cortical thickening
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What are the tumors of the mandible?
- Osteoma- BT, blastic
- Plasmacytoma- PMT, geographic
- Brown tumor- TL, geographic
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What are the tumors of the cervical spine?
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What are the tumors of the thoracic spine?
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What are the tumors of the lumbar spine?
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What are the tumors of the ribs?
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What are the tumors of the pelvis?
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What are the tumors of the humerus?
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What are the tumors of the radius/ulna?
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What are the tumors of the hand/phalanges?
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What are the tumors of the proximal femur?
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What are the tumors of the distal femur?
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What are the tumors of the proximal & distal femur?
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What are the tumors of the proximal tibia/fibula?
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What are the tumors of the proximal & distal tibia/fibula?
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What are the tumors of the foot/ankle?
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What are the tumors in the first decade?
- Ewing's sarcoma-PMT
- Fibrous dysplasia
- Neuroblastoma- SMT
- Osteoblastoma
- Osteochondroma
- Simple bone cyst
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What are the tumors in the second decade?
- Aneurysmal bone cyst
- Chondroblastoma
- Chondroma/enchondroma
- Chondromyxoid fibroma
- Ewing's sarcoma- PMT
- Fibrous dysplasia
- Osteoblastoma
- Osteochondroma
- Osteoid osteoma
- Osteosarcoma- PMT
- Non-ossifying fibroma
- Simple bone cyst
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What are the tumors in the 3rd decade?
- Aneurysmal bone cyst
- Chondroblastoma
- Chondroma/enchondroma
- Chondromyxoid fibroma
- Ewing's sarcoma- PMT
- Giant cell tumor- PQMT
- Non-hodgkins lymphoma- PMT
- Osteoblastoma
- Osteoid osteoma
- Osteosarcoma- PMT
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What are the tumors in the 4th decade?
- Chondrosarcoma- PMT
- Fibrosarcoma- PVMT
- Giant cell tumor- PQMT
- Non-Hodgkin's lymphoma- PMT
- Osteoblastoma
- Parosteal osteosarcoma- PMT
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What are the tumors in the 5th decade?
- Chondromyxoid fibroma
- Chondrosarcoma- PMT
- Chordoma- PVMT
- Hemangioma
- MM- PMT
- Plasmacytoma- PMT
- Metastasis- SMT
- Osteoblastoma
- Parosteal osteosarcoma- PMT
- Paget's disease- TL
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What are the tumors in the 6th decade?
- Chondromyxoid fibroma
- Chondrosarcoma- PMT
- Chordoma- PVMT
- Metastasis- SMT
- MM- PMT
- Paget's disease- TL
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What are the tumors in the 7th decade?
- Chordoma- PVMT
- Metastasis- SMT
- MM- PMT
- Osteoblastoma
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What are the tumors w/ female predilection?
- Osteoma- BT 3:1
- Giant cell tumor- BT 3:2
- Hemangioma- PVBT
- Aneurysmal bone cyst- TL 3:2
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What are the tumors w/ male predilection?
- Chondroblastoma-BT 2:1
- Osteoblastoma- BT 2:1
- Osteochondroma- BT 2:1
- Osteoid Osteoma- BT 2:1
- Chondrosarcoma- PMT 2:1
- Ewing's sarcoma- PMT 2:1
- MM- PMT 2:1
- Non-Hodgkin's lymphoma- PMT 2:1
- Osteosarcoma- PMT 2:1
- Giant cell tumor- PQMT 3:1
- Chordoma- PVMT 2:1
- Non-ossifying fibroma- TL 2:1
- Simple bone cyst- TL 2:1
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What are the tumors with a lytic, moth eaten appearance?
- Ewing's sarcoma- PMT
- Metastasis- SMT
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What are the tumors w/ a lytic, permeative appearance?
- Chondroma/enchondroma- BT
- Ewing's sarcoma- PMT
- Non-Hodgkin's lymphoma- PMT
- Metastasis- SMT
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What are the tumors w/ a lytic, punched out appearance?
MM- PMT
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What are the tumors w/ a blastic, solid appearance?
- Osteoid osteoma- BT
- Osteoma- BT
- Osteosarcoma- PMT
- Parosteal osteosarcoma- PMT
- Metastasis- SMT
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What are the tumors w/ a blastic, cotton wool appearance?
Metastasis- SMT
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What are the tumors w/ a solid periosteal reaction?
Osteoid osteoma- BT
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What are the tumors w/ a laminated periosteal reaction?
- Ewing's sarcoma- PMT
- Non-Hodgkin's lymphoma- PMT
- Metastasis- SMT
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What are the tumors w/ a spiculated periosteal reaction?
- Ewing's sarcoma- PMT
- Non-Hodgkin's lymphoma- PMT
- Osteosarcoma- PMT
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What are the tumors w/ a sunburst periosteal reaction?
Metastasis- SMT
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What are the soap bubble lesions? (MAC FOGS MEN)
- MM
- Aneurysmal bone cyst
- Chondroblastoma
- Fibrous dysplasia
- Osteoblastoma
- Giant cell tumor
- Simple bone cyst
- Metastasis
- Enchondroma
- Non-ossifying fibroma
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What are the tumors w/ pain?
- Chondroblastoma- BT
- Chondromyxoid fibroma- BT
- Osteoblastoma- BT
- Osteochondroma- BT
- Osteoid osteoma- BT
- MM- PMT
- Osteosarcoma- PMT
- Parosteal osteosarcoma- PMT
- Periosteal osteosarcoma- PMT
- Plasmacytoma- PMT
- Metastasis- SMT
- Giant cell tumor- PQMT
- Fibrosarcoma- PVMT
- Aneurysmal bone cyst- TL
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What is the aka for osteochondroma?
exostosis
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What is the aka for chondromyxoid fibroma?
fibromyxoid chondroma
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What is the aka for chondroblastoma?
Codman's tumor
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What is the aka for Giant cell tumor?
osteoclastoma
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What is the aka for Ewing's sarcoma?
round cell tumor
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What is the aka for Non-Hodgkins lymphoma?
- primary reticular cell sarcoma
- round cell tumor
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What is the aka for MM
round cell tumor
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What is the aka for a simple bone cyst?
- solitary bone cyst
- unicameral bone cyst
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What is the aka for non-ossifying fibroma?
fibrous xanthoma
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What is the aka for fibrous dysplasia?
Osteitis fibrosa
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What is the aka for paget's disease?
Osteitis deformans
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Pt presents w/ the following conditions: Location: distal phalynx, age: 28, pain: yes, appearance: well-marginated. What is the differential diagnosis?
Enchondroma: 50% have calcium, epidermoid inclusion cyst is another, glomus tumor is another
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17 yo female presents w/ following conditions: insidious onset & progressively worsening w/ midlumbar pain. No fever/trauma. No response w/ several weeks of care. Goes to another DC. X-rays taken. Appearance: L2 spinous expansile radiolucent lesion
Osteoclastoma, giant cell; actually an aneurysmal bone cyst
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58 yo female presents w/ post treatment appt following 2 yo diagnosis of breast cancer w/ low back pain. After several weeks of care, pt does not respond. What is differential diagnosis?
Possible metastasis; refer if bone scan positive
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58 yo female pt presents w/ post treatment appt following 2 yo diagnosis of rectal cancer w/ low back pain. After several weeks of care, pt does not respond. What is differential diagnosis?
Less likely metastasis; bone scan to confirm
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