Bones, joints, soft tissues (slides 66-159) Flashcards
True or false; osteosarcomas are aggressive malignancies most often forming at knee
true
What is the MC primary bone cancer
Osteosarcoma
“Codman’s Triangle” and/or sundburst appearance on X-Ray appears in patients with what disorder?
Osteosarcoma
True or false; typically osteosarcomas are not painful
false; typically very painful
True or false; cartilage forming tumors are MC benign
true
Osteochondroma - a benign tumor of cartilage MC forms where?
Knee
True or false; osteochondromas are typically multiple in presentation
false; MC solitary - multiple are hereditary (comes with increased sarcoma risk)
A patient with hereditary multiple osteochondromas are typically what age group and gender?
10-30 year old males`
Are chondromas typically benign or malignant? Unilateral or bilateral? Are they painful?
Benign
MC unilateral
MC asymptomatic
Chondromas found in the hand are MC where?
Proximal phalanges
What is more common, chondrosarcomas or osteochondromas
osteochondromas
True or false; chondrosarcomas are MC found intramedullary and rare in distal extremities
true
There are two kinds of chondrosarcomas - Low-grade and High-grade; which is MC? Are they both painful?
Low-grade MC
Yes
High-grade chondrosarcomas are less common than low-grade, but are more likely to metastasize. Where is MC place they would metastasize to?
Lungs
Where would you most likely find chondrosarcomas?
Shoulder, pelvis, or proximal femur
Which malignant bone tumor contains primitive neuroectodermal tumors (PNETs)
Ewing sarcoma
True or false; Both fibrous cortical defects (FCD) & Nonossifying fibromas (NOF) are not true neoplasms
true
What are fibrous cortical defects and nonossifying fibromas?
Benign lesions: fibroblasts and macrophages
Where is the MC place a fibrous cortical defect or nonossifying tumor would occur? Are they typically painful?
MC distal femur (knee)
MC asymptomatic
True or false; typically nonossifying tumors and fibrous cortical defects self resolve in 2-3 years
true
What is fibrous dysplasia? Where do they all come from
Benign lesion - failure of bony differentiation
All from spontaneous GNAS mutations
What are the two kinds of fibrous dysplasia? Which is MC?
Monostotic (one bone effected)
Polyostotic (more than one bone)
Monostotic MC
In monostotic fibrous dysplasia what is the MC bone effected? is it present at birth?
Ribs
No, typically between ages 10-30
Polyostotic fibrous dysplasia which is less common than monostotic effects more than one bone. Which bones are MC effected? Is it more progressive than monostotic?
Femur
Yes - very progressive
True or false; Polyostotic fibrous dysplasia MC effects the femurs just like Paget disease. How do the two diseases differ?
Paget - effects whole shaft of femur
FB - just near the neck
What are the 1st and 2nd MC pediatric bone caners
1st - osteosarcoma
2nd - Ewing sarcoma
True or false; Ewing sarcoma MC effects caucasian males between the age of 10-20 in the femur
true
What bone cancer presents with “onion-skinning” and “sunburtst” periosteum
Ewing sarcoma
True or false; Primitive neuroectodermal tumors (PNET) are associated with homer-wright rosettes
true
Where are giant cell tumors of bone MC
knee
True or false; giant-cell tumors of bone cause arthritis like pain and decreased range of motion
true
True or false; secondary metastasis to bone is MC than primary bone cancers
true
True or false; Carcinomas differ from their spread to bone because they typically do so via hematogenous circulation
false;
Sarcomas - hematogenous
Carcinomas - lymphatics
True or false; secondary metastasis to bone MC occurs in axial skeleton
true
What is the MC joint disorder?
Osteoarthritis
Osteoarthritis causes degeneration of articular cartilage. Which type of cartilage does it effect?
collagen type 2
What is the difference between primary and secondary osteoarthritis
primary - insidious - no trauma - adults
Secondary - predisposing injury - trauma - obesity - systemic disease
Where are the MC places Males get OA? What about Females?
Males - hips
Females - knees and hands
True or false; eburnation (ivory sign) is a clear sing of OA
true
True or false; subchondral cysts are common in OA
True
What kind of hypersensitivity reaction is RA?
type 4
What kind of arthritis are Bouchard’s nodes associated with? What about Heberden’s?
Bouchard’s - RA
Heberden’s - OA
What is ankylosis? Does it occur in OA? What about RA?
fusion of bones at joint space
OA - No
RA - eventually yes
True or false; Boucher’s nodes and swan-neck deformity are both associated with OA
false; both associated with RA
What is Pannus? What kind of arthritis is it associated with?
Destruction of articular spaces
RA
Which arthritis is autoimmune, inflammatory and associated with ankylosis
RA
Which arthritis is degenerative - non-inflammatory, no ankylosis
OA
True or false; unlike normal RA juvenile RA effects large joints instead of small joints
true
What is Marie-Strumpell disease synonymous with?
Ankylosing spondylitis
What is ankylosing spondylitis
axial skeleton : inflammation and ankylosis
True or false; 95% of ankyosing spondylitis patients are positive for HLA-B27 gene
true
What is the difference between primary and secondary gout
Primary - hyperuricemia (increased uric acid production)
Secondary - co-morbid - leukemia, renal disease, lead poisoning
What is the other name for calcium pyrophosphate deposition disease? (CPPD)
Pseudogout
Calcific tendinitis is MC where?
Rotator cuff muscles
What is another name for hydroxyapatite deposition disease (HADD)
calcific tendinitis
True or false; infectious arthritis (septic arthritis) is MC caused by bacteria - specifically staph aureus
true
Suppurative (pus forming) arthritis MC infects what joint?
knee
True or false; lyme disease if left untreated can lead to lyme arthritis
true
An epithelium lined cavity in the body containing liquid or semisolid material best describes what?
a cyst
What is the main difference between a ganglion and synovial cyst?
Ganglion - no communication with synovial joint
Synovial cyst - does communicate with synovial joint
What is a synovial cyst in the popliteal fossa called?
baker cyst
True or false; tenosynovial giant cell tumors are rare in the sense that they are benign yet aggressive
true
