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Bone Path II > Bone Path II Quiz 2 > Flashcards

Bone Path II Quiz 2 Flashcards

1
Q

What is the most common benign tumor of BONE?

A

Osteochondroma

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2
Q

Who does Osteochondromas affect?

A

<20= 75%

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3
Q

What do Osteochondromas look like on film?

A

Single Lesion
Sessile or Pedunculated
Bony exostosis: cortex continuous projecting away from joint.
Cartilagenous cap

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4
Q

Where are most Osteochondromas?

A

85% in Femur, Humerus, Tibia
Metaphysis of long bone
Any bone with cartilagenous cap.

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5
Q

Can Osteochondromas turn malignant?

A

Yes in >30.

Look for Pain, Osseous destruction, ST mass, Thickening of cartilaginous cap

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6
Q

Multiple Osteochondromas are called…

A

Hereditary Multiple Exocytosis

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7
Q

How many lesionsa re seen in Hereditary Multiple Exocytosis?

A

Ave 10, but hundreds possible

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8
Q

What age group does Hereditary Multiple Exocytosis affect?

A

Dx at 2-10

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9
Q

Can Hereditary Multiple Exocytosis become malignant?

A

Yes in 20% cases

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10
Q

What are the signs/symptoms of Hereditary Multiple Exocytosis

A

Painless, lumpy joints

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11
Q

30% of time, Hereditary Multiple Exocytosis results in _ of the wrist

A

Beyonet wrist deformity (Madenlung’s)

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12
Q

What is the most common benign tumor of SPINE

A

Hemangioma

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13
Q

What age group does Hemangiomas affect?

A

Most >40

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14
Q

What do Hemangiomas look like on x-ray

A

Single lesion (lytic)
Normal Cortex
Rare body expansion
Coarse vertical striation “corduroy cloth” appearance

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15
Q

Where do you most commonly find Hemangiomas?

A

75% in Spine & Skull

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16
Q

What are the symptoms of Hemangiomas?

A

Most ASYMPTOMATIC, but can cause neurologic compromise due to location in spine and skull.

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17
Q

Where do you find Osteomas and what do they look like?

A

Osteomas are round/oval well defined sclerotic lesions found in membranous bones (frontal & ethmoid bone)

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18
Q

Are osteomas painful?

A

No, most asymptomatic

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19
Q

What is the Triad of _ called

  • Multiple osteomas
  • Chronic polyps
  • Soft tissue fibromas
A

Gardner’s Syndrome

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20
Q

Is Gardners Syndrome a genetic disorder?

A

Yes, Autosomal dominalt

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21
Q

What is the big dea about polyps found in Gardners Syndrome?

A

They are considered premalignant.

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22
Q

Where can you find Bone Islands?

A

Any bone except skull. Rare in vertebrae.

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23
Q

Describe Bone Islands

A 
Sclerotic
Sharp margins
Solitary Lesion
Round
Homogeneously dence
Radiating Specules (diagnostic)
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24
Q

What is another name for a Bone Island?

A

Enostoma

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25
Q

What age population do Osteoid Osteomas affect?

A

10-25 y.o

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26
Q

What are the Classic Symptoms of Osteoid Osteomas?

A

Increasingly severe, deep, aching pain.
Not relieved by rest, worse at night.
Relieved by asprin.

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27
Q

Can osteoid Osteomas referr pain?

A

Yes, 30% refer to nearby joint.

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28
Q

Do you see swelling, tenderness, or stiffness in osteoid osteomas?

A

Yes.

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29
Q

Where to most Osteoid Osteomas occur?

A

Any bone
Cortical most common
50% in femur and tibia

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30
Q

What are the plain film findings of Osteoid Osteomas?

A

Cortical Lesion (80%)

Reactive Sclerosis

Lucent round nidus

Intramedullary and intracapsilar much less sclerotic

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31
Q

What do you DDX with Osteoid Osteomas?

A

Stress Fracture

Brodies Abscess

Bone Island (normal to bone scan)

Osteoblastoma

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32
Q

Histologically, what are Osteoblastomas similar to?

A

Osteoid Osteomas

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33
Q

What age group does Osteoblastomas affect?

A

70% are <20

34
Q

What are the common locations for Osteoblastomas?

A

Neural Arch of Spine
Long bone Meta/Diaphysis
Hands, Feet, Skull, Face

35
Q

How do Osteoblastomas and Osteoid Osteomas compare in symptoms?

A

Less Painful
Not nocturnal
Not Relieved by Asprin

36
Q

50% of Osteoblastomas in the spine result in what?

A

Painful Scoliosis

37
Q

How does Osteoblastomas affec surrounding tissue?

A

Spasms
Rigidity
Referred pain
Spinal Steonosis

38
Q

What to Osteoblastomas look like in the Spine?

A

Espansile
Thin cortical periphery
Most Lytic

39
Q

What do Osteoblastomas look like in the Extremities?

A

Lytic, expansile
Epiphysis spared
Cortex thin, may disrupt

40
Q

What is the 2nd most common benign tumor of bone?

A

Enchondroma

41
Q

What age groups do Enchondromas usually affect?

A

10-30

42
Q

Are pathologic fractures common with enchondromas?

A

Yes

43
Q

Where do you most commonly find Enchondromas?

A

50% phalanges

50% femur, tibia humerus, ribs.

44
Q

What is noteworthy about Enchondromas near the axial skeleton?

A

They are more ofyten symptomatic and higher likelihood of becoming malignant

45
Q

What do Enchondromas look like on film?

A 
Geographic Lytic
Expansile
Thinned Cortex
Metaphyseal-Diaphyseal
Calcification in 50%
No ST mass
46
Q

What is another name for Multiple Enchondromastosis?

A

Olliers Disease

47
Q

Are Multiple Enchondromasosis bilateral?

A

No, they are unilateral

48
Q

Can Multiple Enchondromatosis Cause growth changes?

A

Yes, often result in shortened limb

49
Q

What is the Malignant Transformation rate of Multiple Enchondromatosis?

A

25-50%->

Osteosarcoma, Chondrosarcoma, Fibrosarcoma

50
Q

Multiple Enchondromatosis with Soft Tissue Hemangiomas/Phleboliths is called _

A

Maffucci’s Syndrome

51
Q

Chondroblastomas are AKA

A

Codman’s Tumor

52
Q

What age group does Chondroblastomas usually affect?

A

5-25

53
Q

What is the local recurrance rate of Chondroblastomas?

A

20%

54
Q

Where do you most often find Chondroblastomas?

A

2/3 lower extermity (50% knee)

Epiphyseal, but may extend into metaphysis.

55
Q

What do Chondroblastomas look like on plain film?

A 
Lytic
Geographic
Epiphyseal
Sharp Zone of Transition
Calcification in 50%
56
Q

What do you DDX with Chondroblastomas?

A

Giant Cell

Clear Cell Chondrosarcomas

57
Q

What age group does Chondromyxoid Fibroma affect?

A

10-30 yo

58
Q

What are the sx of Chondromyxoid Fibromas?

A

Local Pain & Swelling.

59
Q

What is the most common location for Chondromyxoid Fibromas?

A

50% in tibia

60
Q

What are the film findings for Chondromyxoid Fibromas?

A

Eccentric
Lytic
Soap Bubbly

61
Q

Fibrous Xanthomas comprise what two bone tumors?

A

Nonossifying Fibroma

Fibrous Cortical Defect

62
Q

What are the difference between Nonossifying Fibroma and Fibrous Cortical Defect?

A

Nonossifying Fibroma

  • 8-20 yo
  • > 2cm
  • Extends to medullary cavity

Fibrous Cortical Defect

  • 2-8 yo
  • <2cm
  • Cortex
63
Q

What is the outlook for Fibrous Xanthomas? (NOF & FCD)

A

Spontaneous resolution over 2-4 years

64
Q

What % of children have FCD?

A

30-40%

65
Q

Where are Fibrous Xanthomas most often found?

A

90% in tibia or fibula

66
Q

What are the plain film findings for Fibrous Xanthomas?

A 
Lytic, ovoid
Eccentric
Sclerotic boarder
Sclerotic when healing
Mild on bone scan
67
Q

Are Simpe Bone Cysts true neoplasms?

A

No, they are fluid filled cyst

68
Q

What age group does Simple Bone cyst affect?

A

3-14 y/o

69
Q

What are the symptoms of Simple Bone Cysts?

A

They are asymptomatic

70
Q

What is the big risk with Simple Bone cysts?

A

Pathologic fracture

71
Q

How do you reduce recurrance of Simple Bone Cysts?

A

Steroid injection into cyst

72
Q

What is the location of Simple Bone Cysts?

A

Central

75% in Proximal Humerus or Femur

73
Q

What are the plain film findings for Simple Bone Cysts?

A

Geographic, Lytic.

Bone expansion, but not beyond physis.

“Fallen Fragment” sign with fracture

74
Q

A cystic blood filled cavility tumor is called _

A

Aneurysmal Bone Cyst

75
Q

What age group does Aneurysmal Bone Cyst affect?

A

5-20

76
Q

What is the big risk o Aneurysmal Bone Cyst.

What is the recurrence rate?

A

Pathologic Fracture.

Recurrance high

77
Q

What is the treatment for Aneurysmal Bone cyst?

A

Surgery

78
Q

What is the location for Aneurysmal Bone Cysts?

A

Long Tubular Bones
Metaphysis/Diaphyseal
Posterior arch of spine (painful scoliosis)

79
Q

What are the plain film findings of Aneurysmal Bone Cysts?

A 
Expansile
Lytic
Eccentric
Thinned cortex
Metaphysis/Diaphysis
80
Q

What is the only benign tumor to cross growth plate?

A

Aneurysmal Bone Cyst

81
Q

What tumors have a fluid level seen on CT and MRI?

A

Aneurysmal Bone Cyst
Osteosarcomas
Giant Cell Tumors
Chondroblastomas

Bone Path II (5 decks)

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