Dont touch lesions Flashcards
What are the 3 categories of dont touch lesions
Posttraumatic
Obviously benign
Normal variants
What is the presentation of myositis ossificans? How is it different than a malignant calcified mass?
Circumferential calcification with a lucent center
A malignant tumor will have ill defined periphery and central ossification/calcification
What is a cortical desmoid?
Where do they present?
How do they look on radionucleotide scan?
Avulsion off of the medial supracondylar ridge of the distal femur
Posteromedial epicondyle of the femur
Hot
What is the presentation of discogenic vertebral disease?
Who get it?
Focal sclerotic lesion adjacent to an endplate with narrowing of the disc space, osteophytosis
Middle aged woman with low back pain
What causes inferior migration of the humeral head?
Hemarthrosis - pseudodislocation
What should be sought with pseudodislocation? What view should be obtained?
Fracture
Scapular y or axillary view
What is the normal variant - dorsal defect of the patella?
Lucent lesion in the upper outer quadrant of the patella that can mimic OCD, however OCD will be central and is rare in the patella
What is the normal variant - pseudocyst of the humerus?
Lytic lesion under the humeral greater tuberosity due to the increased cancellous bone in this region. Can become more pronounced in trauma or RCT due to hyperemia. Will also be hot in radionucleotide scan.
What is an os odontoideum? What is the treatment?
How does it present radiographically?
Unfused dens that can move anterior to C2 with flexion and simulate a fracture. Tx is surgical as it can be unstable.
Smooth, well corticated inferior border of the dens and the hypertrophied densely corticated anterior arch of C1
What is osteopoikilosis?
How can it be differentiated from mets?
Familial process of multiple bone islands or small areas of osteosclerosis
More centered around the joints as opposed to diffusely throughout the bone
Where is a NOF usually located? How does it look?
Lytic lesion
well defined, sclerotic scalloped border
cortical expansion
metaphysis of long bone
What is a key feature of bone islands?
Grow along the axis of the bony trabeculae
With a patchy or mixed/lytic pattern/permeative lesion, when is a bony infarct most likely?
Multiple lesions in the diametaphyseal region of a long bone or history of lupus or sickle cell
What is the appearance of an early bone infarct?
Patchy demineralization
What is a Pitts Pit
Lytic lesion in the lateral aspect of the femoral neck
caused by surface erosion of the synovium and soft tissues around the hip
