Bone Aggressiveness Flashcards
Bone response to injury and disease
What are the limited number of ways bones change in response to injury and disease?
- Increased opacity – productive or sclerotic changes
- Decreased opacity – osteolysis or osteoporosis
- Periosteal reaction
- Changes in size or contour
Or a combination of the above
Often initially see osteolysis followed by bone production.
Outline Wolff’s law
Bone in a healthy animal will adapt to the loads under which it is placed. If loading on a particular bone increases, the bone will remodel itself over time to become stronger to resist that sort of loading.
The bone correcting a curved healing by depositing bone on the inside shaft, and taking bone away from the outside to straighten the bone
What is the musculoskeletal Mnemonic for evaluation?
A – Alignment/apposition
B – Bones
C – Cartilage
D – Devices
S – Soft tissue
What causes a bone to respond by increasing radio-opacity?
Sclerosis
Increased density of bone
Superimposed periosteal or endosteal reaction
Apparent sclerosis
Superimposition of bones
Osteoporosis
Thickened dense bone due to abnormal
osteoclastic activity.
What causes bone to respond by decreasing radio-opacity?
Seen radiographically after around 7-10 days post injury
Need to loose 30-60% of mineral content before can detect.
Osteomalacia – bone is poor quality, good quantity
Osteopaenia – Bone is poor quantity, good quality
Osteolysis – Abnormal focal area of bone resorption
What are the roentgen signs of osteopenia?
Reduced bone opacity
Cortical thining
Coarse trabeculae
Loss of laminal dure around teeth
What is the feature of diseased bone with radio-lucent changes?
The response is typically a combination of lysis and sclerosis
What response to injury causes this to be more radiolucent?
Presence of periosteal reactions
What response to injury causes this to be more radiolucent?
Changes in contour and shape
How do you assess the aggressiveness of bone lesion?
- Location and distribution
- Presence of cortical distribution
- Pattern of bone lysis and production
- Type of periosteal reaction
- Rate of change of lesion
- Zone of transition
What aspects of location and distribution should you assess?
Location
Generalised or diffuse
Metabolic
Nutritional
Whole limb
Disuse atrophy
Neuropathy
Focal
May be multifocal
Symmetrical
Distribution
- Epiphysis/physis
- Metaphysis
- Diaphysis
- Benign disease anywhere
Where is this bone lesion distributed?
Epiphysis/physis
Where is this bone lesion distributed?
Metaphysis
Where is this bone lesion distributed?
Diaphysis
What terminology is used to describe the number of sites involved?
Monostotic: Primary bone tumours occur principally in the meaphyseal area
Polyostotic: Metastatic tumours often more than one bone involved usually within diaphysis
List the following patterns of lysis in order of least aggressive to most aggressive.
Geographic – uniformly destroyed area with sharply defined border
Moth-eaten – Areas of destruction with ragged borders
Permeative – Permeative, ill-defined area spreading through marrow space
What pattern of lysis is this?
Geographic
What pattern of lysis is this and what is the arrow pointing towards?
Moth eaten
Pathological fracture
What bone lysis pattern is this?
Permeative - with moth eaten on the proximal portion of the bone
Name the different periosteal reactions
What type of periosteal reaction is this?
Solid
What type of periosteal reaction is this?
Lamellar
What type of periosteal reaction is this?
Irregular palisading
What type of periosteal reaction is this?
Spiculated
What type of periosteal reaction is this?
Amorphous
What type of periosteal reaction is this?
Codman’s triangle
