Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Diagnostic Imaging > Aggressive vs. Non-Aggressive Bone Lesions > Flashcards

Aggressive vs. Non-Aggressive Bone Lesions Flashcards

1
Q

How are the 6 Roentgen signs used for assessing bone disease?

A
  1. LOCATION - metaphyseal, diaphyseal, physeal, epiphyseal, proximity to nutritional foramen, centered on joint
  2. SIZE
  3. SHAPE - lysis, proliferation, amorphous, definition
  4. MARGINS - irregular vs regular, ill-defined vs defined proliferation/lysis
  5. NUMBER - polyostoic, monostotic, amount of lesions
  6. OPACITY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How do the patterns of lysis compare in non- aggressive and aggressive bone lesions?

A

NON-AGGRESSIVE = geographic

AGGRESSIVE = moth-eaten, permeative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do periosteal reactions compare in non- aggressive and aggressive bone lesions?

A

NON-AGGRESSIVE = smooth, well-defined, continuous

AGGRESSIVE = irregular, ill-defined, interrupted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does the zone of transition compare in non- aggressive and aggressive bone lesions?

A

NON-AGGRESSIVE = narrow, well-defined

AGGRESSIVE = broad, ill-defined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does the rate of change compare in non-aggressive and aggressive bone lesions?

A

NON-AGGRESSIVE = slow

AGGRESSIVE = fast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does cortical destruction compare in non- aggressive and aggressive bone lesions?

A

NON-AGGRESSIVE = not as typical

AGGRESSIVE = common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is geographic lysis?

A

an indicator of non-aggressive bone lesions where there is a well-defined region of lysis with regular borders and short zones of transition

(open physis = young patient, irregular stifle joint)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is moth-eaten lysis?

A

an indicator of aggressive bone lesions where there are multiple, irregular, and ill-defined regions of lysis that coalesce to form larger regions

(periosteal reaction also seen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is permeative lysis?

A

an indicator of aggressive bone lesions where there are smaller, pinpoint, coalescing regions of lysis that are more ill-defined than moth-eaten and have a broader zone of transition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the periosteum? How long does it take to develop?

A

specialized connective tissue that covers all bones and possessed bone-forming potential (not typically visualized, unless it is mineralized)

7 days after injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Periosteal reactions:

A
  • continuous, smooth, well-defined = non-aggressive
  • interrupted, irregular, ill-defined = aggressive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Codman’s triangle?

A

disruption of cortical regions of bone with elevation due to aggressive processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most common cause of non-aggressive periosteal reactions?

A

callus associated with healed/healing fractures

  • smooth, continuous, well-defined
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What kind of periosteal reaction is associated with low grade or chronic osteomyelitis?

A

smooth and continuous, but more ill-defined

  • assess lymph nodes and swelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Periosteal reaction:

A

smooth, continuous, irregular, well-defined

  • yellow = not as smooth, well-defined
  • green = disrupted periosteum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What do irregular and interrupted periosteal reactions indicate? What are the most common appearances?

A

more aggressive lesions

  • columnar
  • spiculated
  • sunburst
  • amorphous
17
Q

Why is the cortical lysis commonly caused by aggressive bone lesions especially important?

A

can lead to pathological fractures

18
Q

What is the zone of transition? How are they different in non-aggressive and aggressive lesions?

A

distance between normal and abnormal bone in a lesion

  • sharp/well-defined/short = slowly progressing = non-aggressive
  • indistinct/ill-defined/long = rapidly expanding = aggressive
19
Q

Zone of transition:

A
20
Q

What is a polyostotic lesion? What are 2 common causes?

A

aggressive lesion affecting more than one bone

  1. hematogenous/lymphatic spread of metastasis or systemic infection
  2. metabolic/nutritional disease
21
Q

What 2 disorders should be considered if there are polyostotic lesions centered on a joint?

A
  1. joint-centric neoplasia —> synovial cell sarcoma, histiocytic sarcoma
  2. septic/immune-mediated arthritis
22
Q

What is a monostotic lesion? What do features of aggression and non-aggression suggest?

A

lesion affecting only one bone

  • AGGRESSION = primary bone neoplasia, fungal or bacterial osteomyelitis
  • NON-AGGRESSIVE = bone infarction, fracture remodelling, bone cyst
23
Q

How do aggressive and benign lesions compare in rate of change? What can be done to differentiate?

A
  • AGGRESSIVE = change rapidly
  • NON-AGGRESSIVE = change slowly, with minimal alterations in 7-14 day periods

take second radiographs within 7-14 days

24
Q

What 3 parts of the DAMNITV scheme are most commonly associated with aggressive bone lesions?

A
  1. AUTOIMMUNE - immune-mediated arthropathy (rheymatoid arthritis)
  2. NEOPLASIA - primary bone tumor (metaphyseal), metastatic (polyostotic, near nutrient foramen), joint-centric neoplasia
  3. INFECTION - bacteria, fungal
25
Q

Generating a differential diagnosis for aggressive bone lesions:

A
26
Q

Match the descriptors to the appropriate type of bone lesions:

  • regional or pulmonary metastases common
  • does not metastasize
  • sharp, well-defined lesion margins
  • moth-eaten lysis
  • enchondroma
  • osteosarcoma
  • no lysis of surrounding bone
  • moderate to severe soft tissue swelling
  • geographic lysis
  • not associated with pathological fractures
  • associated with pathological fractures
  • smoothly marginated periosteal reaction
  • irregular, ill-defined lesion margins
  • permeative lysis
  • short zone of transition
  • large zone of transition
  • irregular, ill-defined periosteal reaction or osteoproliferation
  • related to trauma
A

AGGRESSIVE - metastasis, moth-eaten lysis, osteosarcoma, moderate to severe soft tissue swelling, associated with pathological fractures, ill-defined lesion margins, permeative lysis, long zone of transition, ill-defined periosteal reaction or osteoproliferation

NON-AGGRESSIVE - no metastasis, sharp and well-defined lesion margins, enchondroma, no lysis, geographic lysis, not associated with pathological fractures, smoothly marginated periosteal reaction, short zone of transition, related to trauma

27
Q

How many radiograpic features of aggression must be present to conclude the lesion you are describing is aggressive?

A

1 —> very conservative

28
Q

Attached are lateral and craniocaudal images of a 10 year old Labrador retriever with progressive lameness and muscle atrophy involving the right pelvic limb. Based on the assessment of the distal tibial lesion, select five features present.

a. irregular, ill-defined, interrupted periosteal reaction
b. smooth, well-defined, continuous periosteal reaction
c. permeative lysis
d. long, ill-defined zone of transition
e. short, well-defined zone of transition
f. cortical disruption
g. geographic lysis
h. severe soft tissue swelling

A

A, C, D, F, H

29
Q

This lesion is centered on which region of bone?

a. diaphysis
b. metaphysis
c. epiphysis

A

B —> distal tibial metaphysis

30
Q

For this lesion, which differential diagnosis would you most likely select as your top differential?

a. septic arthritis
b. primary osseous neoplasia
c. osteomyelitis
d. bone cyst

A

B —> aggressive, distal tibia, Hx (10 y/o Lab)

31
Q

What is the most common primary bone neoplasm in dogs?

A

osteosarcoma

32
Q

What is the general distribution of osteosarcomas? What are the 5 most common regions it is found?

A

“away from the elbow, toward the knee”

  1. distal radius/ulna
  2. distal femur
  3. proximal tibia
  4. scapula
  5. proximal humerus
33
Q

In what region of the bone is osteosarcoma most commonly found? Metastatic lesions?

A

PRIMARY = metaphyseal region

METASTATIC = diaphyseal, reflecting location of the vasculature channel and portal of entry into the bone

34
Q

How is the age distribution of osteosarcoma unique?

A

BIMODAL —-> frequency spikes at 2 years of age and geriatric patients

Diagnostic Imaging (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions