Skel Radd B - midterm

  1. Osteoma
    • Benign
    • Asymptomatic
    • Loc: Membranous Bone, Paranasal/Frontal Sinus, Ethmoidal(MC)
    • Lesions: Don't get >2cm, round/oval, well circumscribed radiopaque
    • Features: A bone hematoma
    • high correlation w/ Gardener's Syndrome, triad of abnormal growth (multiple oseteomas, colonic polyps, soft tissue fibromas)
    • Misc: most require no treatment
  2. Osteoid Osteoma
    aka Giant Osteoid Osteoblastoma
    • Benign
    • age & sex: 10-25 yoa 2:1 male
    • Severe pain, worse at night w/ vasomotor disturbances (sweating, increased temp)
    • loc: metaphysis, localized, pin-point, femur neck of trochanter, tibiam big tubular bones
    • Lesions: geographic, eccentric, solid periosteal, including density around radiolucent nidus, short zone, course trabecul, 3 locations cortical, medullary, b/t periosteum and cortex
    • Features: painful/rigid scoliosis (lesion on concave side): spine, dense pedicle, t.p., facet, lamina
    • MiscL hard to see on plain film, need CT
  3. Osteoblastoma
    • Benign
    • Age & Sex: <20 yoa, 10-20 yoa, 2:1 male
    • Very Rare
    • localized pain; painful scoliosis; not relieved by asprin
    • Loc: neural arch of spine, S.P. T.P. Lamina; metaphysis
    • Lesions: radiolucent, very expansile thin peripheral cortical rim, >2cm
    • Features: rare in spine, paraspinal pleural line
    • Central ScleroticL Teens metatisize to lungs, cod triangle, distal femur; Central Lytic: moth eatten/permeative, tubular bone, Codman's triangle, path fx, no defined geo lesion
    • Misc: may have recent trauma
  4. Parosteal
    • Malignant
    • Rare
    • Localized Pain
    • Loc: Grown out into soft tissue
    • Features: Islands of tumor bone function main tumor, radiolucency between tumor and periosteum
  5. Periosteal
    • Malignant
    • Rare
    • Lesions: between host cortex and periosteum (doesn't enter cortex/bone)
  6. Enchondroma
    • Benign
    • Age: 10-30 peack, 3rd decade
    • Incidence: most common benign bone tumor of hand
    • Asymptomatic
    • Loc: Hands: long small tublar bones or feet/ribs, metaphysis or diaphysis & foot
    • Lesions: thinned cortex, central, well defined margins, endosteal scalloping, radiolucent, geographic, expansice lytic, calcify
    • Features: may show matric calcification on xray; ectopic cartilafe, pathological Fx
    • MISC: Ollier's - multiple bone deformity; Mafucci's Synd. - enchon + soft tissue hemangiomas
  7. Osetochondroma
    aka Bony Exostosis
    • Benign
    • Age: <20; 2:1 male
    • Incidence: Most common benign skeletal tumor overall
    • Asymptomatic
    • Location: Metaphyseal; knee, femur, most common; then humerus, tibia, hip
    • Lesions: An extension of the bone; three presentations: 1. solitary (most common) 2. Multiple/Few (2-3), 3. HME a bunch (20%), bayonet deformity of wrist
    • Features: Pedunculated - "coat hanger exostosis; elongated STALK with narrow blended base of attachment to host away f/ joint from muscle pull; cartilage cap over bony formation of caclification Sessile - NO STALK, wide base of attachment, looks like a bump
    • MISC: If becomes malignant = chondrosarcoma
  8. Fibromyxoidchondroma
    aka Chondromyxoid Fibroma
    • Benign
    • Age: 10-30
    • Incidence: Uncommon
    • Symp: Gets more and more painful as lesion grows
    • Location: proximal tibia
    • lesions: geographic. expansile, soap bubble, radiolucent, eccentric, oval/round, long axis, parallel to bone; endolsteal scalloped border, cortex border thin but defined.
    • MISC: Known as a "Junk" tumor f/ mixed histology
  9. Chondroblastoma
    aka Codman's Tumor
    • Benign
    • Age: 10-25, 2nd decade 2:1 male
    • Rare
    • Symp: PAINFUL, referred to adjacent joint
    • Location: Epiphysis; most common in humeral head, also long bones of lowe extremity and in big apopysis, distal/proximal femur in medullary cavity
    • Lesions: Cotton wool appearance, 3-6 cm; radiolucent, geographic, eccentric, round/oval, lytic, expansile, round, thins cortex
    • Features: Only true tumor to originate in the epiphysis; central calcification, metaphysis periostils
    • MISC: Can lead to collapse of femur head
  10. Chondrosarcoma
    • Malignant
    • Age: 30-50 2:1 male
    • Incidence: 3rd most common primary bone tumor; MC primary malignant tumor of hand
    • Symp: pain late in process, swelling
    • Location: metaphyseal; pelvis, proximal femur and humerous, ribs, scapular, strenum, etc.
    • Lesions: Periosteal = "cleavage plant" between normal bone adn neoplasm; expansile, round/oval radiolucenies with ill defined margins, endosteal scalloping; inside bone
    • Features: Develop from Enchondroma; malignant degeneration of Ollier's disease, closer lesion to axial skeleton, higher protential for malignant degeneration
    • MISC: Osteochondroma becomes malignant Chondrosarcoma
  11. Osetosarcoma
    aka Osteogenic Sarcoma
    • Malignant
    • Age: 10-25 2:1 males
    • Incidence: 2nd most common primary bone tumor
    • Symp: Pain
    • Location: medullary space; long bones of extremities; both femurs and in tibula
    • Lesions: Mottled, permeative, poorly defined sozen of transition. diffuse solid periosteal rxn secondary to hypertrophic osetoarthrophathy extends into soft tissue; dense ivory/sclerotic region filling medial space
    • Features: F/ METS to lungs; hypertrophic osteoarthropathy; TRIAD - 1/ clubbing of digits 2. perioseal rxn 3. peripheral arthritis; may metastasize to lung fields
    • MISC: ET xray P. 1021, knee xray, cannonball met in lung
  12. Giant Cell Tumor of Bone
    aka Osteoclastoma
    • Quasi-Malignant: 80% Benign/20% Malignant
    • Age: 20-40
    • Benign: 3:2 Females; Malignant 3:1 males
    • Incidnece: most common benign of sacrum
    • Symp: localize intermuscular achey pain, restricts movement
    • Location: most in knee, then distal femur, promixial tibia
    • Lesions: Scalloping fo inner cortex (thin & extended) and endosteal, large radiolucencies, eccentric, classic soap bubble lesion, round/oval, poorlu degined margin, wide zone of transistion
    • Features: Adult = subarticular F/ epiphysis and extend up; Highly cascular lesion; neoplasm from non bone forming CT; post tramatic
  13. Ewing's Tumor
    aka Sarcoma
    • Malignant
    • Age: 10-25 TEEN (15)
    • race: LC in Americans
    • Incidence: 4th most common primary malignant bone tumor
    • Symp: Deep, localized achy bone pain; fever/lethargic, mimic osteomyelitis
    • location: diaphysis of larger tubular & flat bones
    • lesions: permeative, classicaly laminated can be spiculated, periosteal reaction (onion peel), bone dest rxn in diaphysis, wide zone of transistion codmans triangles.
    • features: aggressive, fast growing, mixed lesions
    • Misc: MC primary maliginat bones tumor in 1st decade, may see cannonball mets in lungs
Card Set
Skel Radd B - midterm
Flashcards for Skel Radd B midterm