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Diagnostic Imaging II Exam Three > Diagnosis Tips > Flashcards

Diagnosis Tips Flashcards

1
Q

What is the age range for Ewing’s sarcoma?

A

10-25

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2
Q

What is the age range for osteosarcoma?

A

10-25

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3
Q

What is the age range for giant cell tumor?

A

20-40

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4
Q

What is the age range for chondrosarcoma?

A

55-70

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5
Q

What is the age range for myeloma?

A

50-70

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6
Q

What is the most common overall cancer in those aged 0-14 yeas old?

A

Leukemia

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7
Q

What is the general cause of 75% of all malignancies?

A

Metastatic disease

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8
Q

What is the most common primary malignant tumor in adults?

A

Multiple myeloma

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9
Q

What is the most common primary malignant tumor in children?

A

Osteosarcoma

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10
Q

What is the most common benign osseous tumor?

A

Osteochondroma (50%)

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11
Q

What is the most common benign spinal tumor?

A

Hemangioma

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12
Q

At what age do we reach skeletal maturity?

A

25 ish

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13
Q

What predictive factor to diagnosis bone tumors could possibly be considered the most important of them all?

A

Skeletal location

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14
Q

Where is the body does the conversion from red to yellow marrow begin?

A

Distal extremities

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15
Q

Do children have more red or yellow marrow?

A

Red

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16
Q

Why are extremity tumors less common in adults?

A

Red to yellow marrow conversion occurs first in the distal extremities

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17
Q

What is the order of marrow conversation in the parts of long bones?

A

1 epiphysis 2 midshaft 3 metaphyseal ends

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18
Q

What are the patterns of bone destruction in order from least to most invasive?

A

1 geographic 2 moth-eaten 3 permeative

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19
Q

Is the geographic pattern of bone destruction normally benign or malignant?

A

Benign

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20
Q

Does the geographic pattern of bone destruction typically appear as a solitary or multiple lesion?

A

Solitary

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21
Q

When a lesion is well-defined with borders, is it more likely to be benign or malignant?

A

Benign

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22
Q

Which has a longer zone of transition: geographic or moth-eaten pattern of bone destruction?

A

Moth-eaten

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23
Q

What is the term for a radiolucent line seen in the middle of the cortex of bone?

A

Tunneling

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24
Q

Which pattern of bone destruction tends to have the smallest sized lesions?

A

Permeative (1 mm)

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25
Q

Why is permeative bone destruction difficult to see?

A

Lesions are similar in size to normal trabeculae because they’re so small

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26
Q

What is the term for increased cortical thickening of long bones?

A

Buttressing

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27
Q

Are periosteal reactions more commonly seen in adults or children?

A

Children

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28
Q

At what location of bone is the periosteum tight?

A

At metaphyseal corners by the growth plates

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29
Q

What type of periosteal reaction is characterized by additional layers of bone being added to the exterior creating an expanded osseous contour?

A

Buttressing/solid periosteal reaction

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30
Q

Is buttressing more commonly seen with fast or slow growing lesions?

A

Slow

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31
Q

What type of periosteal reaction is characterized by alternating layers of lucency and opacity with a alternating growth of new layers of bone?

A

Laminated/layered/onion skin

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32
Q

Onion skin periosteal reactions are commonly associated with what tumor?

A

Ewing’s sarcoma

33
Q

What type of periosteal reaction is characterized by linear radiating areas of bone growth that appear perpendicular to the bone?

A

Spiculated (“hair on end”)

34
Q

What type of periosteal reaction is characterized by linear radiating areas of bone growth that stem from a central focus of the bone?

A

Sunburst

35
Q

Sunburst appearance is commonly associated with which tumor?

A

Osteosarcoma

36
Q

Which periosteal reaction is characterized by a triangular elevation of periosteum seen at the peripheral lesion-cortex junction?

A

Corman’s triangle

37
Q

Which is considered the most aggressive of the periosteal reactions?

A

Codman’s triangle

38
Q

What are the three possible appearances for cartilaginous matrix of tumors?

A 
1 ring/C-shaped
2 flocculent (popcorn ball like)
3 small crystals (hole with dots)
39
Q

Which is more common: primary or secondary lesion?

A

Secondary (75%)

40
Q

Is bone expansion more likely to occur with a primary or secondary lesion?

A

Primary

41
Q

Do periosteal reactions tend to occur with primary or secondary lesions?

A

Primary

42
Q

What are the most common primary sites of metastatic disease?

A

Breast, lung, prostate, kidney, thyroid, bowel

43
Q

If lytic metastasis is seen in the hands of a female, what is most likely the primary site?

A

Lungs

44
Q

What is probably the #1 cause of lytic metastasis in males?

A

Lungs

45
Q

What is probably the #1 cause of lytic metastasis in females?

A

Breast

46
Q

What is probably the #1 cause of blastic metastasis in males?

A

Prostate

47
Q

What is the most common type of metastasis pathway and how is it accomplished?

A

Hematogenous dissemination (blood) via Batson’s venous plexus

48
Q

Does the Batson’s venous plexus revolve around the axial skeleton or extremities?

A

Axial skeleton (explains location of spine for many secondary tumors)

49
Q

What are some laboratory measurements that can be done for metastatic disease?

A

ESR, serum calcium, alkaline phosphatase, acid phosphatase, PSA antigen

50
Q

What would elevated acid phosphatase and/or PSA antigen levels indicate?

A

Ruptured capsule of prostate

51
Q

What would elevated alkaline phosphate levels indicate?

A

Bony productive disease (blastic disease)

52
Q

What is usually the age range for those with metastasis?

A

Over 40 (past the 4th decade)

53
Q

What is the most common area for metastasis and why?

A

Spine (area of red marrow in adults)

54
Q

What is the order of frequency for common locations of metastasis?

A

Spine, ribs/sternum, pelvis/sacrum, proximal extremities, skull

55
Q

Metastasis to the hands or feet is rare, but if it happens..what primary site should be considered?

A

Lungs

56
Q

What is more common: blastic or lytic metastasis?

A

Lytic (75%)

57
Q

If a “blow out” metastasis occurs, what primary sites should be considered?

A

Thyroid/kidney (maybe hepatocellular carcinoma)

58
Q

What is the name of the radiographic sign when a vertebral body becomes solid white due to blastic metastasis?

A

Ivory vertebra

59
Q

What are the two differentials for a missing pedicle?

A

Congenital defect or metastasis

60
Q

What is the radiographic finding called when there is a missing pedicle?

A

Winking owl sign

61
Q

What are the 3 causes of pathological collapse?

A

1 osteoporosis
2 metastasis
3 multiple myeloma

62
Q

What conditions are most commonly seen to involve solitary ivory vertebra?

A

Paget’s disease, Hodgkin’s lymphoma, osteoblastic metastasis

63
Q

What is the age range for Hodgkin’s lymphoma?

A

20-40

64
Q

What is the age range for Paget’s disease?

A

Over 60

65
Q

What is the age range for osteoblastic metastasis?

A

Over 40

66
Q

If a 50 year old patient presents with a solitary ivory vertebra, what is the most likely cause?

A

Osteoblastic metastasis

67
Q

If a 30 year old patient presents with a solitary ivory vertebra, what is the most likely cause?

A

Hodgkin’s lymphoma

68
Q

If a 70 year old patient presents with a solitary ivory vertebra, what is the most likely cause?

A

Paget’s disease

69
Q

Can yellow marrow ever covert to red marrow?

A

Yes, sometimes in times of crisis when blood is needed

70
Q

When mixed metastasis presents in a female, what is the likely primary site?

A

Still breast

71
Q

When mixed metastasis presents in a male, what is the likely primary site?

A

Prostate (because the majority is blastic)

72
Q

What is the name of the congenital anomaly that presents as multiple bone islands (insult compacta) with increased whitened density that also appear inactive on bone scan?

A

Osteopoikilosis

73
Q

In what location do we commonly seen degeneration due to aging that takes on the appearance of a long bone pseudotumor?

A

Proximal humerus

74
Q

Can bone scans differentiate between lytic and blastic metastasis?

A

No (simply detect metabolic activity)

75
Q

Which is more common: blow out metastasis from kidney or thyroid or primary blow out lesion?

A

Metastasis ALWAYS

76
Q

How can you differentiate between a congenital pedicle defect or an absent pedicle due to metastasis?

A

Old films OR if sclerosis is not present = metastasis

77
Q

Which parameter of MRI is most sensitive to metastasis?

A

T1

78
Q

How does metastasis appear on T1 weighted MRI? T2?

A 
T1 = low signal (dark)
T2 = slightly high signal

Diagnostic Imaging II Exam Three (4 decks)

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