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Clinical Pod Med Exam 3 > Bone Tumors > Flashcards

Bone Tumors Flashcards

1
Q

What is the best radiographic method to diagnose a bone tumor?

A

x-ray

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2
Q

What is your first step when diagnosing a bone tumor?

A

is the lesion latent, active or aggressive?

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3
Q

describe the margin, periosteal reaction and soft tissue mass in a latent bone lesion.

A

narrow margins
no periosteal reaction
soft tissue mass is absent

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4
Q

describe the margin, periosteal reaction and soft tissue mass in an active bone lesion.

A
  • wide margins
  • none or mild periosteal reaction
  • soft tissue mass is absent
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5
Q

describe the margin, periosteal reaction and soft tissue mass in an aggressive bone lesion.

A
  • wide or poorly defined margins
  • mild or major perisoteal reaction
  • soft tissue mass is present
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6
Q

perisoteal reactions occur with what type of lesions?

A

more active/aggressive lesions

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7
Q

what is considered a narrow margin?

A
  1. 1-1.0mm

* tumor and surrounding normal bone are touching

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8
Q

what is considered a wide margin?

A

2-10mm

*can see where the tumor is and the undamaged bone

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9
Q

what is considered a poorly defined margin?

A

several cm

*can tell there is a tumor in teh bone or areas that are distinctly abnormal

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10
Q

what is a geographic lesion?

A

well-defined lesion with a narrow margin

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11
Q

What is a moth-eaten appearance?

A

ill-defined areas of lucency (rathere than a single discrete lesion)

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12
Q

what is a permeative lesion?

A

ill-defined pattern of lucency with many small, irregular holes in the bone
*usually associated with aggressive infection or malignancy

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13
Q

what are the 3 descriptions of appearance of lesions?

A
  1. geographic
  2. moth-eaten
  3. permeative
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14
Q

regarding periosteal reactions, if you see a full layer of solid, uninterrupted perisoteal new bone along the margin of teh affected bone, what does this tell you about the lesion?

A

it is slow-growing

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15
Q

regarding perisoteal reaction, if you see a lamellated or onion-skin appearance of new bone, what does this tell you about the lesion?

A

the lesion grows in fits and starts (on/off growing)

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16
Q

if growth of lesion is very rapid, what 2 patterns may develop?

A
  1. sun-burst or hair-on-end appearance

2. Codman’s triangle

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17
Q

what is sun-burst apeparance?

A

periosteum has no time to lay down bone and Sharpey’s fibers become calcified at different lengths

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18
Q

what is hair-on-end appearance?

A

occurs with rapidly growing lesions because Sharpey’s fibers become calcified at all the same lengths

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19
Q

what is Codman’s triangle?

A

signifies an aggressive lesion because only the edges of the raised periosteum will ossify

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20
Q

what is step 2 of diagnosing bone tumors?

A

ask yourself what does the matrix look like?

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21
Q

a speckled matrix is indicative of what cell origin?

A

chondroid matrix (cartilage cells)

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22
Q

a matrix derived from bone will have what matrix appearance?

A

cloudy matrix

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23
Q

a matrix derived from fluid-filled cysts or hyaline is indicative of what type of lesion?

A

ground glass appearance

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24
Q

Name the cartilage-forming tumors.

A
  1. osteochondroma
  2. solitary enchondroma
  3. chondroblastoma
  4. chondrosarcoma
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25
Q

Name the bone-forming tumors.

A
  1. osteoid osteoma and osteoblastoma

2. osteogenic sarcoma

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26
Q

Which are the benign tumors?

A
  1. enchondroma
  2. osteochodnroma
  3. osteoid osteoma
  4. osteoblastoma
  5. giant cell tumor (also malignant)
  6. chondroblastoma
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27
Q

Which are the malignant tumors?

A
  1. osteogenic sarcoma
  2. chondrosarcoma
  3. fibrosarcoma
  4. Ewing’s sarcoma
  5. metastatic carcinoma
28
Q

what is step 3 of diagnosing bone tumors?

A

is the lesion lytic or sclerotic, solitary or multiple?

29
Q

What is the mnemonic for solitary lytic lesions of bone?

A 
"FOG MACHINES"
F-fibrous dysplasia
O-osteoid osteoma/osteoblastoma
G-giant cell tumor
M-metastasis, myeloma
A-aneurysmal bone cyst
C-chondroblastoma, chondromyxoid fibroma
H-hyperparathyroidism, hemangioma
I-infection
N-non ossifiying fibroma
E-eosinophilic granuloma, enchondroma
S-solitary bone cysts, sarcoidosis
30
Q

What bone tumor is seen with Albright’s syndrome?

A

fibrous dysplasia

31
Q

Which bone tumor appears as a “long lytic lesion in a long bone”?

A

fibrous dysplasia

32
Q

Name this bone tumor: night pain that is relieved by aspirin or NSAIDs
“hurts like a b and is tough to see”

A

osteoid osteoma

33
Q

Name this bone tumor that attacks the ends of long bones (metaphysis) of teenagers. There is no surrounding reactive bone sclerosis.

A

osteoblastoma

34
Q

Name this bone tumor that is massive in the metaphysis and may metastasize to lungs or transform to fibrosarcoma or osteogenic sarcoma?

A

giant cell tumor (of bone)

35
Q

What is the most common primary malignant tumor of bone in the body?

A

multiple myeloma

36
Q

what does multiple myeloma appear as?

A

moth-eaten appearance

multiple punched-out lesions

37
Q

what bone tumor appears as “mosaic glass on MRI”?

A

aneurysmal bone cyst

38
Q

Which bone tumor has a “fluffy, cotton wool appearance”?

A

chondroblasto`ma

39
Q

Name this bone tumor that has a “chicken-wire matrix”.

A

chondromyxoid fibroma

40
Q

what condition produces “brown tumors”

A

hyperparathyroidism

41
Q

Name this bone tumor that has “long striations with long lucencies”

A

hemangiomas

42
Q

which bone tumor appears very similarly to fibrous dysplasia?

A

non-ossifying fibroma

43
Q

which bone tumor appears as “soap bubble appearance”?

A

non-ossifying fibroma

44
Q

Which bone tumor loves the ends of long bones and has “speckled tone”?

A

enchondroma

45
Q

which bone tumor has “endosteal scallopping”?

A

eosinophilic granuloma

46
Q

which bone tumor is almost exclusively in the calcaneus, under the mdidle facet especialy.

A

solitary bone cysts (unicameral bone cysts)

47
Q

which malignant lesion affects those <1 y/o?

A

neuroblastoma

48
Q

which malignant lesion affects ages 1-10?

A

Ewing’s sarcoma

49
Q

Which malignant lesions affects age 10-30?

A

osteosarcoma

Ewing’s sarcoma

50
Q

which malignant lesions affect age 30-40?

A

fibrosarcoma, lymphoma

51
Q

which malignant lesions affect age 40+?

A

metastasis, myeloma, chondrosarcoma

52
Q

which malignant lesion most commonly exhibits onion-skin appearance to the periosteum?

A

Ewing’s sarcoma

53
Q

Ewing’s sarcoma affects which part o fthe foot?

A

1/3 in hindfoot- 30% survival

2/3 in forefoot - 70% survival

54
Q

where does osteosarcoma like to affect?

A

rapidly growing bones, esp knees

55
Q

what is the most common malignant bone tumor of foot and ankle?

A

chondrosarcoma

56
Q

what is the mnemonic for solitary or multifocal sclerotic lesions of bone?

A

COP BOBS HIP

57
Q

COP

A

chronic osteomyelitis
osteochondroma
Paget’s disease

58
Q

BOBS

A

breast metastasis
osteogenic sarcoma
bone island
stress fracture

59
Q

HIP

A

hemangioma
infarct
prostate metastasis

60
Q

Name this tumor: aberrant proliferation of epiphyseal cartilage cells and ceases growth at time of skeletal maturation

A

osteochondroma

61
Q

osteochondroma is similar to subungual exostosis. how do you differentiate this?

A

subungual exostosis is more common in females and does not arise from epiphysis like osteochondroma does
*subungual exostosis arises from distal phalanx

62
Q

what is a bone island?

A

area of sclerotic bone due to increased osteoblastic activity; is benign

63
Q

what is the “flame-shaped” sclerotic lesions of bone?

A

Paget’s disease

64
Q

what looks like “candle wax disease”?

A

melorrheostosis

65
Q

what looks like linear striations?

A

osteopathia striata

66
Q

what looks like spotted bones?

A

osteopoikilosis

Clinical Pod Med Exam 3 (7 decks)

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