Bone and soft tissue tumours

Question 1

Features of a simple bone cyst?

Answer 1

Cavity filled with yellow-coloured fluid.
Benign as does not spread beyond bone.
Active or latent

Question 2

Features of fibrous dysplasia?

Answer 2

Uncommon condition in which scar tissue develops in place of normal tissue.
It can cause weakness of the bone resulting in deformities or fractures

Question 3

Classification of osteomyelitis?

Answer 3

Haematogenous osteomyelitis - results from bacteraemia, most common form in children. Vertebral osteomyelitis is most common form in adults. RFs: Sickle cell anaemia, IVDU, immunosuppresion

Non-haematogenous - Spread from adjacent infection. Polymicrobial and most common form in adults. RFs: diabetic foot ulcers, diabetes mellitus and PAD.

Question 4

Microbiology seen in osteomyelitis?

Answer 4

Staph.aureus is most common cause except in sickle-cell anaemia where salmonella is the most common pathogen.

Question 5

Investigations and management of osteomyelitis?

Answer 5

Ix - MRI.
Rx - Flucloxacillin for 6 weeks. Clindamycin if pen allergic

Question 6

Presentation and causes of discitis?

Answer 6

Presentation - Back pain, systemic upset and neurological features.
Causes - Staph aureus is most common cause, vital, TB or aseptic

Question 7

Investigations and management and complications of discitis?

Answer 7

Imaging - MRI and may need CT guided biopsy. Must do TTE to assess for endocarditis
Rx - IV antibiotics for 6-8 weeks.
Complications - Sepsis or epidural abscess.