Clinical Findings of Tumors Exam 3

Question 1

Giant cell tumor

clinical

Answer 1

• localized pain of an aching nature

- restricted joint motion

Question 2

Solitary osteochondrosarcoma

Answer 2

• most asym, unless surrounding nerves/vessels
• complaint of a painless hard mass
• pain from a fx stalk/cord compression w/ spinal lesions
• Obstructive uropathy from pelvic tumor
• pain and new growth may indicate mal transformation

Question 3

Hereditary multiple exostosis (HME) “diaphyseal achalasia”

clinical

Answer 3

• # from a few to a hundred w/ an avg of 10
• presents as multiple painless hard masses about jts
• cord compression or obstructive uropathy are possible
• malignant transformation ~5-20%

Question 4

Simple/solitary/unicameral bone cyst

clinical

Answer 4

-asymptomatic unless fx

Question 5

Aneurysmal bone cyst

clinical

Answer 5

-acute onset of pain w rapid increase in severity over 6-12 wks

+/-history of trauma

-neurologic signs (radiculopathy or quadriplegia) w/ spinal involvement

Question 6

Osteoblastoma

clinical

Answer 6

-Asymptomatic in

Question 7

Osteoid osteoma

clinical

Answer 7

• tender to touch and pressure
• local pain (95-98%) weeks to yrs in duration, worse at night, decreased by activity*
• salicylates give relieve in 20-30 min in 75-90%

Question 8

Osteoma

clinical

Answer 8

mostly asymptomatic

Question 9

Enchondroma

clinical

Answer 9

usually asymptomatic

Question 10

Hemangiomas

clinical

Answer 10

• most are symptomatic

- symptomatic spinal lesions are due to expansion causing spinal stenosis and cord compression

Question 11

Chondroblastoma

clinical

Answer 11

• often symptomatic for months to years prior to treatment

- mild joint pain, tenderness, joint swelling, and limitation of motion

Question 12

Fibrous cortical defect

clinical

Answer 12

asymptomatic

Question 13

Nonossifying cortical defect

clinical

Answer 13

asymptomatic

Question 14

Paget’s disease

clinical

Answer 14

most are asymptomatic

Question 15

Fibrous dysplasia

clinical

Answer 15

• usually dependent on type of disease and extent

- many are asymptomatic while others may have pain secondary to deformity/fx

Question 16

Fibrosarcoma

clnical

Answer 16

• chief complaint localized pain and swelling of long duration
• 1/3 present with a pathologic fx

Clinical:

• affects long tubular bones in the younger age group
• is eccentric at diaphyseal-metaphyseal jxn into metaphysic
• affects flat bones in the older age range

Question 17

Sacrococcygeal chordoma

clinical

Answer 17

-LBP (70%), rectal bleeding (42%), sacral mass (17%), constipation, sciatica, frequency and urgency on micturation

Question 18

Spheno-occipital chordoma

clinical

Answer 18

-orbitofrontal headaches, ptosis, visual disturbances, 6th nerve palsy/ paraplegia

Question 19

Vertebral chordoma

clinical

Answer 19

-back pain and radiculopathy

Question 20

Multiple myeloma

clinical

Answer 20

• pain is the initial cardinal symptom
• unexplained weight loss
• cachexia
• bacterial infection (respiratory)
• anemia
• renal disease
• respiratory disease
• deossification of bone
• production of abnormal serum and urinary proteins

Question 21

Osteosarcoma

clinical

Answer 21

• painful selling (1-2 months duration)
• pain initially insidious and transient becoming severe and persistent
• minor restriction of joint motion
• possible limp
• fever

Question 22

Chondrosarcoma

clinical

Answer 22

• development of a lg soft tissue mass
• late development of pain
• duration of symptoms

Question 23

Ewing’s sarcoma

clinical

Answer 23

• severe localized pain
• palpable soft tissue mass
• fever, secondary anemia, leukocytosis and increase ESR simulating infection