Bone and Cartilage Pathology II Flashcards
lump on rib, full of hemosiderin
brown tumor
renal osteodystrophy
skeletal changes that occur in chronic renal disease
tubular dysfunction
generalized renal failure
decreased production of secreted factors
metabolic acidosis
overlying skin intact with fx
simple
bone breaks through skin surface
compound
bone fragmented with fx
comminuted
ends of bones are not aligned with fx
displaced
slowly developing fracture that follows period of increased physical activity where bone subject to repeated loads
stress
fx only partially through bones
greenstick
in kids - with soft bones
fx from weak bone with underlying disease
pathologic
osteopenia, osteomalacia, hyperPTH, growth retardation in patient with chronic renal failure
renal osteodystrophy
result of hyperPTH
osteoporosis
brown tumors
osteitis fibrosa cystica
corticosteroid use
can lead to osteonecrosis
avascular necrosis
with dislocation of hip
cut off blood supply via the obturator artery
osteonecrosis
often affects medulla infarcts
cortex - collateral blood flow
fat necrosis - saponification
inflammation of bone and marrow secondary to infection
osteomyelitis
pyogenic osteomyelitis
hematogenous spread
extension from contiguous site
direct implantation - with surgery
majority of pyogenic osteomyelitis
staph aureus
50% cases - no organism isolated
sickle cell osteomyelitis
salmonella
sequestrum
with osteomyelitis infection
-necrosis of dead bones**
involucrum
shell of living tissue (new bone) around sequestran necrotic dead bone in osteomyelitis
brodie abscess
small intraosseous abscess with osteomyelitis
sclerosing osteomyelitis of garre
jaw - associated with extensive new bone formation that obscures much of underlying osseous structures
Xray with lytic focus of bone surrounded by sclerosis
suggest diagnosis of osteomyelitis
pott disease
tuberculous spondylitis
first hint of bone tumor
pathologic fractures
bone tumors
majority - benign - in younger patients
older adults - likely malignant
most common bone tumor
metastatic
osteoid osteoma and osteoblastoma
B9 bone producing tumor
osteoblastoma is >2cm
osteoblastoma
greater than 2cm
23yo M heel hurts at night
lytic tumor
-osteoid osteoma
at epiphysis
giant cell tumor
at diaphysis
ewing sarcoma
nidus
central lytic lesion in osteoid osteoma and osteoblastoma
surrounded by reactive bone that is thicker
most common primary bone tumor
osteosarcoma
osteosarcoma
malignant
cancerous cells produce osteoid matrix or mineralized bone
common site of osteosarcoma
knee
age of osteosarcoma
bimodal
- 75% >20yo
- 25% older adults
more in men
painful progressively enlarging mass of knee
osteosarcoma
codman triangle
Xray finding - triangular shadow between cortex and raised ends of periosteum
in osteosarcoma - not diagnostic
mets of osteosarcoma
lung
tx osteosarcoma
neoadjuvant chemo
surgery
prognosis of osteosarcoma
60-70% 5 year without mets
exostosis
osteochondroma
benign cartilage capped tumor that is attached to underlying skeleton by bony stalk
most common benign bone tumor
osteochondroma
growth of osteochondroma
stop growing at time of growth plate closure
tx of osteochondroma
symptomatic - simple excision
chondroma
benign tumor of hyaline cartilage
enchondroma
chondroma from medullary cavity
juxtacortical chondroma
chondroma from surface of bone
solitary metaphyseal lesion of tubular bones of hands and feet
enchondroma
Xray circumscribed lucencies with central calcifications, sclerotic rim, and intact cortex
enchondromas
ollier disease
multiple chondroma - nonhereditary disorders characterized by multiple enchondromas
maffucci syndrome
multiple chondroma - and spindle cell hemangiomas
risks with maffucci syndrome
developing ovarian carcinoma and brain gliomas