Ch 26: Benign Disorders of Bone

Question 1

A patient presents to you with a 2 day history of severe flank pain. The patient is depressed, and also mentions to you achey pains in their legs and hands. Blood work reveals high serum calcium, and the radiology report states they have “brown tumors.”
What is the diagnosis? What is the most likely cause of disease?

Answer 1

Diagnosis: Hyperparathyroidism with osteitis fibrosa cystica
Cause: Benign fibroadenoma of 1 or more parathyroid glands

Question 2

A 65 year old patient comes to see you with severe bone pain in their pelvis and head. On x-ray you see flame-shaped lysis of the cortex in the skull and larger than normal bones in the pelvis.
What is the diagnosis? What is the pathologic cell of this condition?

Answer 2

Diagnosis: Paget disease

Pathologic cell: Osoteoclast

Question 3

A 22 year old male patient presents with extreme nocturnal leg pain especially on nights following drinking. He states that the pain is relived by aspirin.
What is the diagnosis? What would you expect the surgical excision to show?

Answer 3

Diagnosis: Osteoid Osteoma
Excision: Thin irregular woven bone within vascular stroma surrounded by reactive sclerotic bone

Question 4

You see a patient with chronic kidney disease requiring dialysis for the past 3 years who presents with metastatic calcification of a one joint and her eyes.
What is the diagnosis? What causes this disorder?

Answer 4

Diagnosis: Renal Osteodystrophy
Causes: Hyperphosphatemia (not filtered well) and hypocalcemia (no vitamin d hydroxylation = no intestinal absorption) and in turn high PTH

Question 5

A toddlers parents bring her in with irregular pigmented macules down her chest, back and sacrum. She had previously been seen for endocrine dysfunction resulting in precocious puberty. Radiographs show lucent ground glass lesions in the bone.
What is the diagnosis?

Answer 5

Diagnosis: Fibrous Dysplasia, Mccune Albright Syndrome

Question 6

<p>A 12 year old male comes to you complaining of joint pain in his knee, saying that he has noticed some swelling in the area. An x-ray shows eccentric radiolucent, sharply defined, small lesion of the distal femur. What is the diagnosis?</p>

Answer 6

<p>Diagnosis: Chondroblastoma</p>