6. Random Ass Colection of Trivia Flashcards
Liposclerosing Myxofibroma
Very characteristic location - at the intertrochanteric region of the femur.
Geographic lytic lesion + sclerotic margin
10% - malignant transformation
Osteochondroma
Actually, it’s usually listed as the most common benign tumor (“exostosis”)
RADIATION induced only benign skeletal tumor associated with radiation.
Osteochondroma
Point away from the joint
can classically poke the popliteal artery and cause a pseudo aneurysm
Multiple Hereditary Exostosis
AD condition with multiple osteochondromas.
They can be sessile or pedunculated. They have an increased risk of malignant transformation.
Trevor Disease (Dysplasia Epiphysealis Hemimelica - DEH)
Osteochondroma in epiphysis = joint feormity
ANKLE and KNEE - Point INTO the joint
CHILDREN
Supracondylar Spur (Avian Spur)
This is an Aunt Minnie, and normal variant. This is an osseous process, that usually does nothing, but can compress the median nerve if the Ligament of Struthers smashes it.
Supracondylar Spur (Avian Spur)
Notice this thing points towards the joint, that is how you know it is not an osteochondroma. Also - it is not a Trevor Disease thing - because of
(1) the characteristic location and
(2) it is not originated from the epiphysis.
Periosteal Chondroma (Juxta-Cortical Chondroma)
When you see a lesion in the finger of a kid think this. It’s a rare entity, of cartilaginous origin.
“Saucerization” of the adjacent cortex with sclerotic periosteal reaction can be seen.
Periosteal Chondroma (Juxta-Cortical Chondroma)
“Saucerization” of the adjacent cortex with sclerotic periosteal reaction can be seen.
Osteofibrous Dysplasia
Benign
Exlcusivley in the TIBIA and FIBULA
< 10 y.o.
When I say looks like NOF in the anterior tibia with anterior bowing
Osteofibrous Dysplasia.
Distal Femoral Metaphyseal Irregularity (Cortical Desmoid)
If they show you a lateral knee x- ray, and there is an irregularity or lucency on the back of the femur this is it.
This is a total incidental finding and is a don’t touch lesion. Don’t biopsy it, Don’t MRI it.
Distal Femoral Metaphyseal Irregularity (Cortical Desmoid)
“Scoop like defect” with an “irregular but intact cortex.”
This is a lucency seen along the back of the posteriomedial aspect of the distal femoral metaphysis.`
Calcium Hydroxyapatite:
= calcific tendinitis.
The calcium is deposited in tendons around the joint
most common location = shoulder, supraspinatus tendon
Secondary causes worth knowing are: chronic renal disease, collagen-vascular disease, tumoral calcinosis and hypervitaminosis D.
Osteopoikilosis:
It’s just a bunch of bone islands.
Osteopoikilosis tends to be joint centered (clustered around centered).
Sclerotic mets will be all over the place.
Osteopathia Striata
Linear, parallel, and longitudinal lines in metaphysis of long bones. Doesn’t mean shit (usually - but can in some situations cause pain).
Engeimann’s Disease
progressive diaphyseal dysplasia or PDD.
Things to know:
It’s Bilateral and Symmetric
It likes the long hones - usually shown in the tibia
It can involve the skull - and can cause optic nerve compression
Thalassemia
This is a defect in the hemoglobin chain (can be alpha or beta - major or minor).
“hair-on-end” skulls, expansion o f the facial bones, “rodent faces,” expanded ribs “jail-bars”. It is frequently associated with extramedullary hematopoiesis.
Thalassemia
Thalassemia vs Sickle Cell
Thalasemia = obliterates sinuses
Sickle cell = will no obliterate sinuses
AVN of the Hip
Kids = perths, sickle cell, Gauchers, Steroids
Can be traumatic
AVN of the hip
Rim sign
AVN of the hip
Crescent sign
Refers to a subchondral lucency seen most frequently in the anterolateral aspect of the proximal femoral head. It indicates imminent collapse.
Plain Film Stages of Osteonecrosis
Zero = Normal
One = Normal x-ray, edema on MR
Two = Mixed Lytic / Sclerotic
Three = Crescent Sign, Articular Collapse, Joint Space Preserved
Four = Secondary Osteoarthritis
Paget Disease (Osteitis Deformans)
M>F
Most people = asymptiomatic
The phrase “Wide Bones with Thick Trabecula” make you immediately say Pagets (nothing else really does that).
O f all the tumors to which Paget may devolve to. Osteosarcoma is the Most Common.
Paget Disease (Osteitis Deformans)
Most common complication of Pagets
Deafness
Two Flavors of Pagets
Comes in two flavors:
(1) Monostotic and
(2) Polyostotic - with the poly subtype being much more common (80-90%).
Phases of Pagets
PAgets
Thickened sclerotic appearance is a good chronic look. Involves BOTH inner and outer table (Fibrous Dysplasia favors the outer table)
Pagets
SKull in Lytic and Mixed phases
Tam O ’Shanter Sign: Skull sorta looks like one of those stupid hats with the frontal aspect “falling over the facial bones”
Pagets
Long bones
Pagets
Pelvis
Pagets
Spine
Cortical Thickening can cause a “picture frame sign” (same as osteopetrosis). Also can give you an ivory vertebral body.
