Bone Injuries and Benign Lesions Flashcards
What is a nonossifying fibroma?
It is a common benign bony lesion made up of fibrous tissue.
What is the recommended treatment for nonossifying fibromas?
No treatment is necessary for nonossifying fibromas.
What are the two types of bone cysts?
Unicameral (fluid-filled) and Aneurysmal (blood-filled)
How do bony cysts and fibromas typically present?
Most are asymptomatic and found incidentally on imaging performed for other reasons. They are noncancerous, typically solitary, and occur in children and young adults. Symptoms can include pain, limp, and fracture (because of weakened bone).
What is the treatment for unicameral bone cysts?
Observation with serial plain films and, for large lesions (>50% of the bone), activity restriction to prevent fracture. They resolve spontaneously with physeal closure.
What is the treatment for aneurysmal bone cysts?
Aneurysmal bone cysts are benign but aggressive and require surgical treatment.
What is traumatic myositis ossificans?
It is characterized by extraskeletal ossification following blunt soft tissue trauma.
How does traumatic myositis ossificants typically present?
This disorder typically occurs in active adolescents after trauma and presents as a painless, enlarging mass most often located in the quadriceps, brachialis, or deltoid muscles.
What are some characteristics of traumatic myositis ossificans seen on x-ray?
It is located away from a joint, is rounded, and is characterized on x-ray by mature peripheral ossification with a distinct margin surrounding a radiolucent center of immature osteoid and primitive mesenchymal tissue. ***find picture?
How can traumatic myositis ossificans be differentiated from neoplasm on x-ray?
The peripheral maturation with central immature osteoid tissue is the reverse of the pattern typically seen in neoplastic conditions. Additionally, the mass in traumatic myositis ossificans is always slightly separated from the long shaft of the bone.
What is the recommended treatment of traumatic myositis ossificans?
Treatment consists of rest, muscle stretching, and antiinflammatory agents. Surgical excision is rarely warranted (usually only if it interferes with joint mobility or is irritating a nerve) - and only after a period of 6-12 months with a negative bone scan.
Why must surgical excision, if indicated, be delayed for at least 6-12 months in patients diagnosed with traumatic myositis ossificans?
Earlier removal will likely result in return of new bone formation within the muscle.
