Benign Bone Tumors (DX imaging)

Question 1

Osteochondroma

Answer 1

• MC BBT of the appendicular skeleton
• pedunculated AKA coat hanger exostosis AKA cauliflower (or mushroom)-like
• or sessile AKA broad based
• multiple osteochondromas= HME (hereditary multiple exostosis)
• 20% under go malignancy

Question 2

Unicameral Bone Cyst (UBC) AKA Simple Bone Cyst (SBC)

Answer 2

• Dia/Meta location
• CENTRALLY located
• FLUID filled tumor
• does NOT cause bone expansion
• <20yoa
• assoc. w/ “fallen fragment” sign

Question 3

Aneurysmal Bone Cyst (ABC)

Answer 3

-Dia/Meta location
-ECCentrically located
-BLOOD filled tumor
-CAN expand the bone
-“finger in balloon”/blister of bone appearance
-<20yoa
[**only one to cross epiphyseal growth center!]

Question 4

Giant Cell Tumor (GCT)

Answer 4

-Epi/Meta location
-“soap bubble appearance”/saponaceous
-20-40yoa
[>case mgmnt: -surgical consult, curettage, refer for biopsy, refer to orthopedist]

Question 5

Chondroblastoma

Answer 5

• Epi/Meta

- <20yoa

Question 6

Osteoid Osteoma

Answer 6

• *causes bone expansion
• night pain relieved with APIRIN
• radiolucent NIDUS w/severe reactive sclerosis

Question 7

Brodie’s Abscess AKA Chronic Osteomyelitis

Answer 7

• night pain relieved by ASPIRIN

- appears like osteoid osteoma

Question 8

Enchondroma

Answer 8

MC BBT of the HAND

• stippled (tiny white dots) appearance
• mult. = OLLIER’S disease (->10-50% malignant)
• w/ST calcification= MAFFUCCI’S syndrome

Question 9

Hemangioma

Answer 9

• MC BBT of the SPINE
• vasular neoplasm (over proliferation of blood vessels in medulla)
• vertical striations AKA “corduroy cloth” AKA “jail bar”
• if seen in ever VB = osteoporosis
• can cause: VB expansion, skull enlargement & spinal stenosis
• case mngmnt: -refer to ortho., continue ADL, adj. to pt. tolerance

Question 10

Enostoma

Answer 10

-bone island

Question 11

Osteopoikilosis

Answer 11

• mult. bone islands (tiny white dots, symm in size/shape)
• *MC in: humerus, pelvis, hands, feet
• NO labs (incidental finding & asymp.)

Question 12

Osteoblastoma

Answer 12

• DDX: Giant Cell Tumor & ABC)
• *MC BBT to affect NEURAL ARCH
• case mgmnt: surgical curettage & excision, radiation
• NOT resolved: spinal canal stenosis, decr. vibration sense, spinal cord compression

Question 13

Osteoma

Answer 13

• *MC BBT to affect the SKULL
• MC found in the FRONTAL sinus
• best see on the CALDWELL projection

Question 14

Fibrous Dysplasia

Answer 14

• most asymp.
• bowing deformities
• assoc. w/ “rind sign” (thick sclerotic border)
• deformity: “saber shin tibia”/”sheppard’s crook”
• “ground glass” appearance
• “cafe au lait” (hyper-pigmented, NON-elevated macules)
• w/”coast of MAINE” appearance (jagged, irregular borders)

Question 15

Neurofibromatosis

Answer 15

• present with Scoliosis, cervical Kyphosis
• IVF enlargement
• “cafe au lait” spots
• w/”Coast of California” appearance (smooth edges)

Question 16

Purpose of taking cervical oblique?

Answer 16

to see the IVF

Question 17

2 conditions causing bone deformity:

Answer 17

1-Fibous Dysplasia

2-Paget’s (medulla whiter on X-ray than adjacent ST)