Benign Bone Tumours

Question 1

what is the most common benign bone tumour

Answer 1

osteochondroma

Question 2

what is osteochondroma derived from

Answer 2

aberrant cartilage from the perichondrial ring

Question 3

inheritance seen in multiple hereditary exotosis

Answer 3

autosomal dominant

Question 4

what can be a cause of multiple osteochondroma

Answer 4

multiple hereditary exotosis

Question 5

pathophysiology of osteochondroma

Answer 5

bony outgrowth on the external surface with a cartilaginous cap

Question 6

presentation of osteochondroma

Answer 6

painless hard lump
may be symptoms on activity: pain from tendons, numbness from nerve compression

Question 7

most common site of osteochondroma

Answer 7

near the knee

Question 8

main investigation for osteochondroma

Answer 8

x-ray

Question 9

x-ray of osteochondroma shows…

Answer 9

cartilage capped ossified pedicle

Question 10

what can be a complication of osteochondroma

Answer 10

transformation into chondrosarcoma

Question 11

management of osteochondroma

Answer 11

observation, remove any lesion growing in size or causing pain

Question 12

what is the 2 most common benign bone tumour

Answer 12

enchondroma

Question 13

what causes enchondroma

Answer 13

failure of normal chondral ossification at the growth plate

Question 14

when do enchondroma usually present

Answer 14

20-50

Question 15

where can enchondroma occur

Answer 15

femur, humerus, tibia and small bones of the hands and feet

Question 16

how may enchondroma present

Answer 16

pathological fracture due to weakened bone
mostly incidental findings

Question 17

investigation of enchondroma

Answer 17

x-ray

Question 18

appearance of enchondroma on x-ray

Answer 18

patch sclerotic appearance

Question 19

management of enchondroma

Answer 19

scaping out and filled with bone graft to strengthen if needed

Question 20

what is a simple bone cyst

Answer 20

single cavity benign fluid filled cyst in a bone

Question 21

clinical presentation of simple bone cyst

Answer 21

usually incidental but can cause pathological fracture

Question 22

management of simple bone cyst

Answer 22

curettage and bone grafting +/- stabilisation

Question 23

aneurysmal bone cyst

Answer 23

many chambers which are filled with blood or serum

Question 24

pathophysiology of an aneurysmal bone cyst

Answer 24

lesion is locally aggressive causing cortical expansion and destruction

Question 25

presentation of an aneurysmal bone cyst

Answer 25

painful mass/swelling pathological fracture

Question 26

management of aneurysmal bone cyst

Answer 26

curettage and grafting or use of bone cement

Question 27

is a giant cell tumour of bone benign or malignant

Answer 27

benign

Question 28

x-ray of giant cell tumour of bone

Answer 28

soap bubble appearance

Question 29

histology of giant cell tumour of bone

Answer 29

multi-nucleated giant cells

Question 30

complication of giant cell tumour of bone

Answer 30

can met to the lung with benign pulmonary GCT

Question 31

management of giant cell tumour of bone

Answer 31

Intralesional excision with use of phenol, bone cement or liquid nitrogen

Question 32

what is fibrous dysplasia

Answer 32

benign developmental disorders that causes normal tissue to be replaced by fibrous tissue

Question 33

when does fibrous dysplasia usually occur

Answer 33

in adolescence

Question 34

monostotic fibrous dysplasia

Answer 34

affects one bone

Question 35

polyostotic fibrous dysplasia

Answer 35

affects multiple bones

Question 36

shepherd's crook deformity on x-ray

Answer 36

fibrous dysplasia of the femur

Question 37

management of fibrous dysplasia

Answer 37

bisphosphonates to reduce pain stabilisation of pathological fractures

Question 38

who usually gets osteoid osteoma

Answer 38

children 5-25

Question 39

common sites for osteoid osteoma

Answer 39

proximal femur, diaphysis of long bones and the vertebrae

Question 40

clinical presentation of osteoid osteoma

Answer 40

intense constant pain, worse at night

Question 41

what can relieve the pain caused by osteoid osteoma

Answer 41

NSAIDs

Question 42

investigations of osteoid osteoma

Answer 42

x-ray but CT to confirm diagnosis

Question 43

CT of osteoid osteoma

Answer 43

small nidus of immature woven bone surrounded by an intense osteoblastic rim

Question 44

management of osteoid osteoma

Answer 44

some resolve spontaneously CT guided radiofrequency ablation or enbloc excision