Bone tumors and tumor like lesions A

Question 1

This radiograph offer the most diagnostic information

Answer 1

Plain radiograph

Question 2

Basic approach to a solitary lesion

Answer 2

Age, sex, SYMPTOMS
Location
Rate of Growth
Periosteal reaction 
Matrix

Question 3

3 primary bones that are more frequent in females

Answer 3

Parosteal osteosarcoma
Giant cell tumor
ABC-very slightly

Question 4

Are sarcomas painful?

Answer 4

yes

Question 5

if you have pain when in physical acticity?

Answer 5

stress fracture

Question 6

Possible locations for lesions

Answer 6

Metaphyseal, epipheseal, or diaphyseal
Cortical or medullary
Eccentric or central

Question 7

Rate of growth

Answer 7

Permeative
Moth-Eaten
Geographic

Question 8

Permeative

Answer 8

Wide zone of transition malignancies and aggressive osteomylitis

Question 9

Moth Eaten

Answer 9

Intermediate both benign and malignant

Question 10

Geographic

Answer 10

Short zone of transition-benign tumors and cysts but also low grade malignancies

Question 11

chondrosarcoma is what kind of growth?

Answer 11

Geographic

Question 12

Periosteal reaction can be

Answer 12

Single layer
Onion Skin
Perpendicular
Codman’s triangle

Question 13

single layer periosteal reaction

Answer 13

Osteomylitis, benign tumors, but also sometimes malignancies

Question 14

onion skin periosteal reaction

Answer 14

Repeated insults (Osteosarcoma and Ewing sarcoma )

Question 15

perpendicular periosteal reaction

Answer 15

Spiculated, Sunburst , almost always malignant

Question 16

Tumor matrix can be

Answer 16

Osseous cloud like , amorphous
Cartilage -punctate , C-shaped
Fiborooseeus -ground glass
No visible Matrix -Pertinent negative

Question 17

Role of CT imaging

Answer 17

For evaluation of locations that are hard to visualize ie: pelvis, sacrum, Scapula
to distinguish cortical from medullary lesions
to evaluate for tumor matrix

Question 18

Role of MR imaging

Answer 18

Better evaluations of sift tissue extent and masses
Evaluation of marrow extent for therapy planning
Usually adds little diagnostic information primary bone lesions

Question 19

Osteoid Osteoma

Answer 19

Central nidus less than 1 cm
Etiology unclear -reactive vs benign neoplasm
more in 2nd and 3rd decades

Question 20

location of osteoid Osteom

Answer 20

50% in tib/fib, spine posterior elements

Question 21

symptoms of Osteiod sarcoma

Answer 21

Dull pain
Worse at night
Relieved with Salycilates
in spine , painful scoliosis 
6-24 months before diagnosis 
when intraarticular might mimic Juvenal Rh with synovitis and joint effusion

Question 22

Radiographic findings fore Osteiod sarcoma

Answer 22

Realctive sclerosis lucent nidus
may have central calcifications ,
CT can be helpful
MR can be misleading

Question 23

treatment options for Osteiod sarcoma

Answer 23

medical
surgical
RF ablation