Exam 1: Cont. Flashcards
Congenital kyphosis caused by
Abnormalities during embryogenesis
Congenital kyphosis affects
Thoracic spine
Type 1 congenital kyphosis
Incomplete formation of one or more vertebral bodies
Type 1 congenital kyphosis can cause
Spinal compression
Type 2 congenital kyphosis
Failed segmentation of vertebral bodies
Type 2 congenital kyphosis MC in
Thoracic region
Severe spinal cord damage is ___ in type 2 congenital kyphosis
Less common
Most bone tumors are
Benign
As size increases, tumor can cause
Local tissue deformation
Pain
Weaken bone
Risk factors for LBP of cancerous origin
>50 yo History Cachexia LBP not relieved with rest LBP >1 month Failure to improve
MC cancer in bone has ____ and is not____
Metastasized
Primary bone cancer
Types of bone forming CA
Osteoid osteoma
Osteoblastoma
Both types of bone forming Ca are
Benign
Osteoid osteoma size
<2cm
MC osteoid osteoma develop near
Cortex of bones in lower extremity
Sex 2X more likely to get osteoid osteoma
Males
Ages MC for osteoid osteoma
10-20
Tumor appearance in osteoid osteoma
Round/oval
Central nidus
Treatment for osteoid osteoma
Aspirin
Symptom of osteoid osteoma
Severe nocturnal pain
Osteoblastoma size
> 2cm
Osteoblastoma MC in what bone
Vertebral column
Osteoblastoma is ___ than osteoid osteoma
Less common
Osteoblastoma treatment
Surgical
Osteosarcoma is ___ and aggressive
Malignant
Osteosarcoma destroys periosteum and ____
Medullary cavity
10-20% of osteosarcomas Mets to
Lungs
___ and ___ mutations are common in osteosarcoma
RB and TP53
Retinoblastoma syndrome increases risk for
Osteosarcoma (1000X)
MC primary bone cancer
Osteosarcoma
Osteosarcoma affects ___ between ages ___
Adolescents
10-20
Secondary osteosarcoma affects >40 yo and associated with
Paget disease
AVN
Irradiation
Aggressive periosteal reactions
On X-ray, early lifting off of bone (codman triangle)
Secondary osteosarcoma has ___ response to treatment
Poor (fatal)
Location MC for osteosarcoma
Metaphysis of distal femur, proximal tibia, humerus
3 types of Cartilage forming tumors
Osteochondroma
Enchondroma
Chondrosarcoma
Osteochondroma is
Benign
Osteochondroma affects what cartilage
Hyaline
___ affected 3X more often in osteochondroma
Males
Age for osteochondroma
10-30
Forms of osteochondroma
Solitary
Multiple hereditary osteochondroma
Multiple hereditary osteochondroma
Familial mutated TSG
Childhood onset
Risk for malignant transformation
Osteochondroma MC at
Knee
Osteochondroma can be painful if
Fractured
Compress other tissues
Enchondroma is ___ and effects what cartilage
Benign
Hyaline
_____ is more rare that endochondroma
Juxtacortical chondroma
Age for enchondroma
20-50
Hallmark of enchondroma
Solitary lesions of hands (and feet)
Multiple enchondroma aka
Ollier Disease
Ollier Disease due to
Sporadic mutation
2nd MC primary bone ca
Chondrosarcoma
Age range for chondrosarcoma
40-60 yo
____ rare in distal extremities
Chondrosarcoma
“Stippled” or “popcorn” calcification common with
Chondrosarcoma
High radiolucency means
Darker
MC chondrosarcoma
Low grade
Low grade chondrosarcoma
Thickens cortex
Slow growing
High grade chondrosarcoma
Large mass
Erodes cortex
70% of high grade chondrosarcoma Mets to
Lungs
Fibrous or fibro-osseous Tumors
Fibrous cortical defect (FCD)
Fibrous Dysplasia
Tumors with unique cells
Ewing sarcoma
Giant cell tumor of bone
FCD >3 cm is called
Nonossifying fibroma (NOF)
Both FCD and NOF are
Benign tumors of fibroblasts and macrophages
FCD is very common, present in ___ of kids
40%
NOF is more ___ than FCD
Rare
FCD and NOF manifest ____ near cortex
Metaphysis or diaphysis
Fibrous Dysplasia results from
Failed bony differentiation
All fibrous Dysplasia is from
Spontaneous GNAS mutations
MC fibrous Dysplasia
Monostotic FD
Little or no body distortion is observed in which FD?
Monostotic FD
Age range for monostotic FD
10-30 yo
Age range of polyostotic FD
Late childhood/ adolescence
Severe deformation, with craniofacial involvement, observed in which FD
Polyostotic FD
“Shephard’s crook” and “ground glass” appearance typical of
Polyostotic FD
McCune-Albright Syndrome has what components
Skeletal
Skin
Endocrinopathy
Classic signs of McCune-Albright syndrome
- Unilateral bony lesions (femur and tibia)
- Cafe au lait spots on skin
- Precocious puberty
Ewing sarcoma and primitive neuroectodermal tumor (PNET) are variants of same
Malignancy
2nd MC Pediatric bone CA
Ewing sarcoma
10 % primary bone Ca
Ewing sarcoma
Subset of Ewing sarcoma with neural differentiation
PNET
PNET has ____
Homer-wright rosettes
Ewing sarcoma age range
10-20 yo
Ewing sarcoma primary affects ____
Caucasians
Ewing sarcoma effects what region of bone
Diaphysis of long bones
Ewing sarcoma can mimic
Infection
Onion skinning observed in
Ewing sarcoma
Granulomas
Collection of macrophages
Giant cell tumor of bone composed of
Multinucleated giant cells
Giant cell tumor of bone MC near
Knee
Age range for giant cell tumor of bone
20-40
Soap bubble appearance observed in
Giant cell tumor of bone
Causes arthritis like pain
Giant cell tumor of bone
Giant cell tumor of bone is osteolytic and
Eccentric (off to side)
Giant cell tumor of bone : benign ____ malignant
>
MC site of Mets to bone
Spine
Sarcomas Mets
Hematogenous
Carcinomas Mets
Lymphatics
Location for Mets to bone
Red marrow
Axial skeleton
Mets to bone can be lytic, blastic, or mixed, and ___ is most common
Mixed
Lytic appears
Dark
Blastic appears
Light
In adults, prostate cancer is
Blastic
In adults, breast ca is
Lytic
In adults, lung ca is
Mixed
