General MSK

Question 1

Fibrous Dysplasia

What is the DDx and Mx ?

Answer 1

Fibrous Dysplasia

DDx:

1. Paget’s disease
2. Osteofibrous dysplasia - almost exclusively in tibia with anterior bowing lesion begins in cortex usually seen in children <10 years
3. Adamantinoma - 80% seen in the tibia
   may appear indistinguishable
4. Simple bone cyst
5. Giant cell tumour
6. Enchondromatosis (see case below)

Mx: Nil; Small risk of sarcomatis transformation in polyostotic form

Question 2

DDx for Intervertebral Disc Calcification

Answer 2

Intervertebral Disc Calcification DDx

• Degenerative : relatively common and may occur in up to 6 % in routine abdominal radiographs in adults - see image below
• Post operative / traumatic
• Ochronsosis : very dense central (nucleus pulposus) calcification associated with osteopaenia.
• Ankylosing spondylitis : associated findings should be visible
• Pseudogout (CPPD) : annulus fibrosis calcification.
• Haemochromatosis : annulus fibrosis calcification
• Juvenile chronic arthritis (JCA)
• Amyloidosis
• Poliomyelitis
• Acromegaly