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pod exam 3 > 50/51: Bone Tumors - Mahoney > Flashcards

50/51: Bone Tumors - Mahoney Flashcards

1
Q

best radiologic test to help diagnose bone lesions, including tumors

A

x-ray

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2
Q

when do you do a biopsy?

A

last step

- do not do if you will not be treating the malignancy or the center of biopsy performance will not be performing biopsy

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3
Q

latent

A

thin sclerotic or radiolucent narrow margin (0.1-1.0 mm), no periosteal reaction, absent soft tissue mass

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4
Q

active

A

wide (2-10 mm) margin, none or mild periosteal reaction, absent soft tissue mass

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5
Q

aggressive

A

wide or poorly defined margin, mild or major periosteal reaction, soft tissue mass present

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6
Q

several ill-defined areas of lucency

A

moth eaten - aggressive

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7
Q

ill-defined pattern of lucency caused by many small irregular holes in the bone

A

permeative - aggressive infection or malignancy

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8
Q

geographic lesions

A

lesion grows slowly, bone has time to retreat and lay down new bone around the lesion

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9
Q

lesion grows in fits or starts, periosteum has time to lay down thin shell of new bone before the leion starts another growht sput

A

lamellate/ onion skin

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10
Q

sun burst/ hair on end

A

periosteum has no time to lay down bone, but sharpey’s fibers bevome stretched out perpendicular to bone and then ossify

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11
Q

codman’s triangle

A

only the edges of the raised periosteum will ossify - this little bit of ossification forms a small angle with the surface of bone, but not a complete triangle

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12
Q

non-metastatic diseases the produce periosteal reactions

A

HEATHV

hypertrophic pulmonary osteoarthropathy
endosteal hyperostosis
acromegaly
thyroid acropachy
hypervitaminosis A
*** venous stasis
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13
Q

what is bone matrix?

A

substance in bone produced by osteoblasts AND chondroblasts

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14
Q

speckled

A

chondroid matrix

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15
Q

cloudy

A

osseous matrix

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16
Q

ground glass

A

fibrous, cystic lesion producing little or no calcification

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17
Q

4 cartilage forming tumors

A

osteochondroma
solitary enchondroma
chondroblastoma
chondrosarcoma

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18
Q

2 bone forming tumors

A

osteoid osteoma and osteoblastoma

osteogenic sarcoma

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19
Q

benign tumors

A 
enchondroma
osteochondroma
osteoid osteoma
osteoblastoma
giant cell tumore (10% malignant)
chondroblastoma
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20
Q

malignant tumors

A 
osteogenic sarcoma
chondrosarcoma
fibrosarcoma
ewing's sarcoma
metastatic carcinoma
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21
Q

FOG MACHINES

A

solitary lytic lesions of bone

Fibrous dysplasia
Osteoid osteoma/osteoblastoma
Giant cell tumor

Metastasis, myeloma
Aneurysmal bone cyst
Chondroblastoma, chondromyxoid fibroma
Hyperparathyroidism, hemangioma
Infection
Non-ossifying fibroma
Eosinophilic granuloma, enchondroma
Solitary boe cyst, sarcoidosis
22
Q

long lesion in a long bone

A

fibrous dysplasia or non-ossifying fibroma (moves into marrow space)

23
Q

hurts like a b and tough to see

A

osteoid osteoma

  • night pain relieved by ASA or NSAIDS
  • produces high amounts of prostaglandins
24
Q

at the end of a long fast, teens have a blast

A

osteoblastoma

- most common tumor in teens at the ends of the long bones

25
Q

osteoid osteoma v osteoblastoma

A

no surrounding reactive bone sclerosis in osteoblastoma

26
Q

massive in metaphysis

A

giant cell tumor

27
Q

most common primary bone malignancy in body

A

metastasis/myeloma

28
Q

metastasis to bone

A

adult male - lung
adult female - breast
also kidney and thyroid

29
Q

1 primary metastasis to foot and ankle bone

A

colorectal CA

30
Q

most common primary malignatnt tumor of bone in body

A

myeloma

31
Q

mosaic glass on MRI

A

aneurysmal bone cyst

32
Q

multiple punched out lesions

A

multiple myeloma

33
Q

chicken wire matrix

A

chondroblastoma (also consider osteoblastoma if young age group)

34
Q

brown tumors

A

hyperparathyroidism (hemosiderin deposition)

35
Q

bubbly lesions of bone - NFC GAMES

A 
Non-ossifying fibroma
Fibrous dysplasia
Chondrosarcoma
Giant cell tumor
Aneurysmal bone cyst
Metastatic CA
Enchondroma/Ewing's sarcoma
Solitary bone cyst
36
Q

end of bone, with speckled tone

A

enchondroma

37
Q

endosteal scalloping

A

eosinophilic granuloma

38
Q

where does solitary bone cyst love to be?

A

under middle facet in calcaneus

“best bet is middle facet”

39
Q

fallen fragment sign

A

solitary bone cyst

40
Q

multiple lucent bone lesions

A

HIFEM

Hyperparathyroidism/hemangioma
Infection
Fibrous dysplasia
Enchondroma/eosinophilic granuloma
Metastasis/ myeloma
41
Q

lytic lesions in metaphysis

A

CAGE ON MUD

Chondroblastoma
Aneurysmal bone cyst
Giant cell tumor
Enchondroma/ewing’s sarcoma

Osteoblastoma/sarcoma/myelitis
Non-ossifying fibroma

Malignant fibrous histiocytoma(fibrosarcoma)
Unicameral bone cyst
Desmoid tumor

42
Q 
malignant lucent bone lesion by age ***
less than 1 yo
1-10 yo
10-30 yo
30-40 yo
40+
A 
neuroblastoma
ewing's sarcoma
osteosarcoma/ ewing's
fibrosarcoma, lymphoma
metastasis, myeloma, chondrosarcoma
43
Q

most common primary bone malignancy in foot and ankle

A

chondrosarcoma

44
Q

moth-eaten or onion-skin with a soft tissue mss

A

ewing’s sarcoma

45
Q

best place to get ewing’s sarcoma

A

70% survival forefoot

30% survival rearfoot

46
Q

solitary of multifocal sclerotic lesions of bone

A

COP BOBS HIP

Chronic osteomyelitis
Osteochondroma
Paget’s disease

Breast metastasis
Osteogenic sarcoma
Bone island
Stress fracture

Hemangioma
Infarct
Prostate metastasis

47
Q

most common bone tumor in foot and ankle

A

osteochondroma

48
Q

develops from epiphysis and ceases growth growing away from the epiphysis

A

osteochondroma

49
Q

how is a subungual exostosis different than an osteochondroma?

A
  • more common in females
  • has fibrocartilage cap
  • does not arise from epiphysis
  • from capillary hemangioma
50
Q

flame-shaped or blades of grass sclerotic lesions of bone

A

pagets disease

51
Q

globular bone sclerosis

A

MOM POO

Melorrheostosis "candle wax dz"
Osteopathia striata-linear striations
Metastasis
Pyknodysostosis- dense and brittle
Osteopoikilosis - spotted bones
Osteomyelitis
52
Q

candle wax disease

A

melorrheostosis

pod exam 3 (16 decks)

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