Bone and soft tissue tumours Flashcards
What is a common location for a sarcoma to spread to Haematogenously?
Lungs and fascial planes
Name suspicious signs of soft tissue tumours on examination
deep, subcutaneous>5cm, rapidly growing, hard and craggy
commonest primary malignant ‘bone’ tumour in older patient
Myeloma
commonest primary malignant bone tumour in younger patient
Osteosarcoma
What is a Red flag symptom of a bone tumour
Deep ache which is worse at night and at rest, persistent and increasing
What should you look for on examination of the bone mass
measurement, location, shape, consistency, mobility, tenderness, temperature, neurovascular deficits
Cardinal Malignant features of bone tumours are…
unexplained pain of a deep seated and boring nature worse at night, difficulty weight bearing (loss of function), deep swelling, joint effusion, neurovascular effects, fractures
What is the Ix of choice/ most sensitive for a Osteosarcoma?
MRI
On Ix what is found on XR if the tumour is active?
clear margins, surrounding rim of reactive bone, cortical expansion
On Ix what is found on XR if the tumour is inactive?
unclear margins, cortical destruction, periosteum is reactive, onion skinning pattern
On Ix why is an isotope bone scan used?
assessing ossification, cortex integrity, staging primarily for the lungs
On Ix why is CT used?
staging for skeletal metastases
What method can differentiate between benign and malignant?
tissue diagnosis
16f back pain, isotope bone scan shows uptake at the left proximal humerus
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32m #distal tibia, developed anterior knee pain which is deteriorating. # slow to heal, develops fixed flexion deformity of his knee
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