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OMF Pathology > 14.1 Bone Pathology > Flashcards

14.1 Bone Pathology Flashcards

1
Q

What are features of benign bone neoplasias?

A
  • asymptomatic
  • symmetrical
  • displaces teeth
  • expands cortex
  • corticated rim on radiograph
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2
Q

What are features of malignant bone neoplasias?

A
  • symptomatic
  • asymmetrical
  • extends past cortex
  • ill-defined borders
  • destroys adjacent structures, including teeth
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3
Q

osteogenesis imperfecta is a defect in what?

A

Collagen Type I maturation

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4
Q

What is the most common inherited bone disease?

A

osteogenesis imperfecta

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5
Q

How does osteogenesis imperfecta present clinically?

A
  • blue sclera
  • altered teeth (brown to blue)
  • long bone/spine deformities
  • hearing loss
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6
Q

What is this feature called?

A

Wormian bones of the skull (mosaic pattern)

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7
Q

What disease is this feature associated with?

A

Osteogenesis Imperfecta

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8
Q

What type of Osteogenesis imperfecta is the mildest and most common, and which is the most severe?

A

Type I is mildest

Type III is most severe

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9
Q

What is also known as the “marble bone disease”?

A

osteopetrosis

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10
Q

What is adult-type osteopetrosis also called?

A

Benign osteopetrosis

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11
Q

What is unique about this patient’s radiograph?

A

Bone is more radiopaque than normal. Probably has osteopetrosis.

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12
Q

What are these lesions caused by?

A

Osteopetrosis caused his bone to necrose, leading to these fistulous tracts.

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13
Q

Why are this child’s eyes blue?

A

osteogenesis imperfecta

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14
Q

Pt sits down in chair and presents with these teeth. Eyes are blue and legs are bowed. What are you thinking they might have?

A

osteogenesis imperfecta

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15
Q

What are characteristics of infantile osteopetrosis?

A
  • poor prognosis
  • marrow failure
  • facial deformities
  • frequent fractures
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16
Q

This is clearly not natural. What could they have if their teeth are also involved?

A

cleidocranial dysplasia

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17
Q

This pano looks good right? No. What does this patient have?

A

cleidocranial dysplasia

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18
Q

What are some features of Cleidocranial dysplasia?

A
  • prolonged retention of primary teeth
  • supernumary teeth
  • clavicular hypoplasia
  • high-arched palate
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19
Q

What is an increased radiolucency of the bone marrow called?

A

Focal Osteoporotic Marrow Defect

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20
Q

Features of Focal Osteoporotic Marrow Defect?

A
  • no jaw expansion
  • ill-defined borders
  • fine central trabeculations
  • typically asymptomatic
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21
Q

Define Idiopathic Osteosclerosis.

A

A focal area of increased radiodensity that is of unknown cause but cannot be attributed to anything else

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22
Q

What is this? (hint: no hx of infection)

A

Idiopathic osteosclerosis

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23
Q

What is this?

A

idiopathic osteosclerosis

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24
Q

What are radiographic features of idiopathic osteosclerosis?

A
  • well-defined borders
  • usually associated w/ root apex
  • more radiopaque than surrounding bone
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25
Q

How should you treat idiopathic osteosclerosis?

A

No treatment is necessary unless there are symptoms or the bone pathology keeps growing

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26
Q

Pt has a clinically obvious Mn deformity and reports pain. You report extreme tooth mobility in Q3. What could this be?

A

massive osteolysis

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27
Q

This pathology presents more in children and young adults, and is seen more in the Mn than the Mx. It typically results with the total loss of the bone affected. What is this?

A

massive osteolysis

(pt has obvious deformity, pain, tooth mobility, and deviation of the mandible)

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28
Q

What bone pathology is abnormal deposition and resorption of bone, commonly polyostotic, and forms near joints?

A

paget’s disease of bone

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29
Q

What sign is noted when pt has paget’s disease of the skull?

A

Increasing circumference of the skull

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30
Q

What is leontiasis ossea?

A

A “lion-like” facial deformity where the middle 1/3 of the face is enlarged (seen in Paget’s disease)

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31
Q

What is the appearance of bone upon radiograph in Paget’s disease of bone?

A

cotton wool or cotton roll

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32
Q

The cotton roll appearance of bone here may suggest what pathology?

A

Paget’s disease of bone

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33
Q

How would you describe this pt’s mandible? What polyostotic disease is this?

A
  1. cotton wool appearance
  2. paget’s disease of bone
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34
Q

What bone pathology frequently occurs in the anterior mandible and crosses the midline?

A

Central Giant Cell Granuloma

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35
Q

What two other pathologies should be tested for if you think it’s central giant cell granuloma?

A

brown tumor of hyperthyroidism and cherubism

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36
Q

This pathology is not considered a neoplastic condition, and frequently involves the anterior Mn. What is this?

A

Central giant cell granuloma

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37
Q

This will histologically appear like brown tumor of hyperthyroidism. What is this?

A

central giant cell granuloma

38
Q

What is this developmental jaw condition that usually goes away by 30 years old?

A

cherubism

39
Q

What are two physical features of people with cherubism?

A
  1. plump cheeks
  2. upturned eyes
40
Q

What is the disease course of cherubism?

A
  1. Dx usually between 2-5
  2. Disease progresses through puberty
  3. Disease usually resides by 30
41
Q

What is this?

A

Cherubism

42
Q

What is a traumatic bone cyst?

A

A benign, empty, or fluid filled cavity within the bone.

43
Q

Why is the name traumatic bone cyst a misnomer?

A

Because the cavity is NOT lined by epithelium like a true cyst.

44
Q

What is this cavity called? (hint: not lined by epithelium)

A

Traumatic bone cyst

45
Q

You get into this bone during surgery and find no epithelial lining. What is your likely diagnosis?

A

Simple bone cyst

(aka traumatic bone cyst)

46
Q

What a unique radiographic feature seen in simple bone cysts?

A

“scalloped” border along the tooth roots

47
Q

What age range is most popular to see Traumatic bone cysts?

A

10-20 yrs

48
Q

You see a radiolucent area on the radiograph and upon surgery find this. What is this? (hint: hole was there and no lining was seen in hole)

A

Traumatic bone cyst

49
Q

Define Aneurysmal Bone Cyst.

A

An intraosseus accumulation of blood-filled spaces surrounded by connective tissue.

50
Q

Why is an Aneurysmal bone cyst not a true cyst?

A

It doesn’t have an epithelial lining

51
Q

Unilateral x-ray finding on 20 year old patient. They report pain and that it developed quickly. What could this be?

A

Aneurysmal bone cyst

52
Q

What age is most common to see an aneurysmal bone cyst?

A

20 yrs old

53
Q

What is the most common clinical sign of an aneurysmal bone cyst?

A

Rapid swelling of the mandible

54
Q

Image shows intraosseus bone surrounded by connective tissue. What is this?

A

Aneurysmal bone cyst

55
Q

What is the clinical appearance of an Aneurysmal bone cyst?

A

A “blood-soaked” sponge

56
Q

What are three examples of fibro-osseous lesions?

A
  1. fibrous dysplasia
  2. cemento-osseous dysplasia (types: focal, periapical, florid)
  3. ossifying fibroma
57
Q

What kind of benign fibro-osseous lesion is characterized by the replacement of normal bone by fibrous CT with altered bone?

A

Fibrous dysplasia

58
Q

Define polyostotic.

A

Involving multiple bones

59
Q

What types of fibrous dysplasia are there?

A

Monostotic and polyostotic.

60
Q

What are two syndromes associated with polyostotic fibrous dysplasia?

A
  1. Jaffe-Lichtenstein syndrome
  2. McCune-Albright syndrome
61
Q

Polyostotic fibrous dysplasia, coast of maine cafe au lait spots, and multiple endocrinopathies are diagnostic for which syndrome?

A

McCune-Albright syndrome

62
Q

What is the radiographic evidence of monostotic fibrous dysplasia?

A

A “ground-glass” appearance

63
Q

Bone has a ground-glass appearance. What is this?

A

Monostotic fibrous dysplasia

64
Q

Radiograph suggests fibrous dysplasia and pt has coast of maine cafe au lait spots. What syndrome might they have?

A

Jaffe-Lictenstein syndrome

65
Q

If your pt presents with polyostotic fibrous dysplasia, cafe au lait spots (coast of maine), and reports very early puberty - what syndrome might they have?

A

McCune-Albright syndrome

66
Q

What is the most common fibro-osseous lesion encountered in clinical practice?

A

Cemento-osseous dysplasia

67
Q

Focal cemento-osseous dysplasia occurs most commonly in what demographic?

A

African-american (and 90% are females)

68
Q

What differentiates focal cemento-osseous dysplasia from Idiopathic osteosclerosis and condensing osteitis?

A

A thin radiolucent rim around the lesion.

69
Q

Pt is a 40 yr old black female. What can the radiograph be showing?

A

Focal cemento-osseous dysplasia

70
Q

What is the physical difference between focal, periapical, and florid cemento-osseous dysplasia?

A

Focal is local to one tooth

Periapical is root(s)

Florid is generalized

71
Q

Based on the RO core and RL border of this lesion, what kind of cemento-osseous dysplasia is this?

A

Periapical

72
Q

What area of the mouth is involved with periapical cemento-osseous dysplasia?

A

Anterior mandible

73
Q

What could this florid condition be?

A

Florid cemento-osseous dysplasia

74
Q

Biopsy of florid COD can cause what to happen to the bone?

A

Can become necrotic from hypovascularity

75
Q

Root divergence or resorption can occur with what kind of benign fibro-osseous lesion?

A

ossifying fibroma

76
Q

What unique physical feature shows with large ossifying fibromas?

A

A downward bowing of the inferior cortex of the mandible

77
Q

Do ossifying fibromas undergo malignant transformation?

A

Nopers

78
Q

Ossifying fibroma occurs more in the Mx or Mn? And in females or males?

A

Mn > Mx

F > M

79
Q

Does juvenile ossifying fibroma occur more in the Mn or Mx? And in females or males?

A

Mn < Mx

F < M

80
Q

What are the two variants of juvenile ossifying fibroma?

A

Trabecular and Psammomatoid

81
Q

Is this psammomatoid or trabecular juvenile ossifying fibroma?

A

Psammomatoid

82
Q

What is a benign tumor of mature bone called?

A

Osteoma

83
Q

What location of osteoma is most common?

A

paranasal sinus

84
Q

Multiple osteomas might be a sign the patient has ________ _________.

A

Gardner syndrome

85
Q

Gardner Syndrome is characterized by what manifestations?

A
  • colonic polyps/adenocarcinoma
  • skeletal abnormalities
  • pigmented ocular fundus
  • supernumerary teeth
86
Q

T or F: Colonic polyps in Gardner Syndrome WILL transform into adenocarcinoma.

A

True

87
Q

What is the most common skeletal abnormality of Gardner Syndrome?

A

osteomas

88
Q

Both osteoblastomas and osteoid osteomas produce prostaglandins, but which one is relieved by aspirin?

A

Osteoid osteomas (because they’re smaller than 2cm and produce less prostaglandins)

89
Q

What is an odontogenic neoplasm of cementoblasts that’s almost always seen in the molar/premolar region?

A

Cementoblastoma

90
Q

Is the PDL dinstinctly visible in cementoblastomas?

A

No, and the cementoblastoma is surrounded by a thin RL rim

91
Q

What is this?

A

cementoblastoma

92
Q
A

OMF Pathology (21 decks)

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