CORTEXT Basic Science

Question 1

Benign or Malignant - Osteochondroma

Answer 1

Benign

Question 2

Benign or Malignant - Endochondroma

Answer 2

Benign

Question 3

Osteochondroma

Answer 3

common bony outgrowth covered in a cartilaginous cap

Question 4

Endochondroma

Answer 4

an intramedullary and usually metaphyseal cartilaginous tumour

Question 5

Brodie’s abscess

Answer 5

a lytic lesion of the bone

Question 6

Giant cell tumour

Answer 6

benign, but can be locally aggressive and a tendency for the epiphyses. may be painful and cause pathological fracture

Question 7

Red flags for malignant bone tumours

Answer 7

Constant pain which may be worse at night.

weight loss, fatigue, loss of appetite. <25 or >60yrs should be investigated

Question 8

Signs of bony malignancy on x-ray

Answer 8

cortical destruction, periosteal reaction, new bone formation and extension into soft tissue envelope

Question 9

Most common form of bone malignancy

Answer 9

osteosarcoma

Question 10

Most common site for osteosarcoma

Answer 10

Knee (60%)

other locations include the proximal femur, proximal humerous and pelvis

Question 11

Chondrosarcoma

Answer 11

cartilage producing primary bone tumour- less common and less aggressive than osteosarcoma

Question 12

Common sites for chondrosarcoma

Answer 12

pelvis and proximal femur

Question 13

Common age group for Ewing’s sarcoma

Answer 13

Teenagers

Question 14

Radiological sign of Ewing’s sarcoma

Answer 14

onion skin pattern

Question 15

Genetics of Ewings sarcoma

Answer 15

t11;22 translocation on the EW sarcoma gene on chromosome 22

Question 16

Associated signs and symptoms of Ewing’s Sarcoma

Answer 16

fever, raised inflammatory markers and warm swelling

Question 17

Common misdiagnosis of Ewings Sarcoma

Answer 17

osteomyelitis

Question 18

Description of an Ewings Sarcoma tumour

Answer 18

small round blue cell tumours

Question 19

Primary treatment of bone tumours

Answer 19

surgery which may include amputation

Question 20

Staging investigations of bone tumours

Answer 20

CT and MRI and bone scan

Question 21

Normal margin of bone tumour removal

Answer 21

3.4cm of bone and a cuff of normal muscle all around

Question 22

How can Lymphoma be involved in primary bone cancer?

Answer 22

can occur as a primary bone tumour from the bone marrow

Question 23

Where does myeloma arise from?

Answer 23

the bone marrow

Question 24

Common cancers which metastasise to the bone

Answer 24

breast cancer, prostate cancer, lung cancer, renal cell cancer, thyroid cancer

Question 25

Bones commonly involved in metastases

Answer 25

vertebra, pelvis, ribs, skull, humerus, and long bones of the lower limb