Lecture 6: Principles of musculoskeletal image interpretation: aggressive vs nonaggressive bone lesions

Question 1

Which image is aggressive vs non-aggressive and why

Answer 1

Left- aggressive- lysis, periosteal reactions, polyostotic
Right: non-aggressive- proliferation but not lytic

Question 2

what are some causes of aggressive bone lesions

Answer 2

1. Primary bone neoplasia
2. Primary soft tissue neoplasia
3. Metastatic bone neoplasia
4. Bacterial osteomyelitis
5. Fungal osteomyelitis

Question 3

what are some signs of aggressive bone lesions

Answer 3

1. Bone lysis
2. Periosteal reaction
3. Rate of progression
4. Zone of transition
5. Cortical lysis

Question 4

is this an aggressive or non-aggressive lesion. Identify 1-2

Answer 4

aggressive
1. Bone lysis
2. Periosteal reaction

Question 5

what is degree of bone lysis called

Answer 5

progression

Question 6

What wrong- aggressive or nonaggressive

Answer 6

bone lysis- aggressive

Question 7

what are the two types of periosteal reactions

Answer 7

continuous and interrupted

Question 8

what can cause a continuous periosteal reaction

Answer 8

callus, slow growing neoplasia

Question 9

what can cause an interrupted periosteal reaction

Answer 9

neoplasia, osteomyelitis

Question 10

which is more aggressive: continuous or interrupted periosteal reactions

Answer 10

interrupted because likely neoplasia or osteomyelitis

Question 11

what type of periosteal reaction is this

Answer 11

continuous periosteal reaction

Question 12

what type of periosteal reaction is this

Answer 12

Interrupted

Question 13

the faster the progression = more ___

Answer 13

aggressive

Question 14

a regular, distinct margin zone of transition means the lesion is aggressive or non-aggressive

Answer 14

non-aggressive

Question 15

an irregular, indistinct margin zone of transition means the lesion is non-aggressive or aggressive

Answer 15

aggressive

Question 16

Is cortical lysis aggressive or non-aggressive

Answer 16

aggressive

Question 17

is cortical thinning aggressive or non-aggressive

Answer 17

non-aggressive

Question 18

what indicated by 1 and is it aggressive or non-aggressive

Answer 18

cortical lysis- aggressive

Question 19

generalized bone lesions are more likely due to __ or __

Answer 19

metabolic or nutritional

Question 20

focal bone lesions are more likely __

Answer 20

primary bone tumors

Question 21

multifocal bone lesions are likely due to __spread and could be __ or __

Answer 21

hematogenous, neoplasia bacterial osteomyelitis

Question 22

how would you classify the location of this lesion: generalized, focal, multifocal

Answer 22

generalized- affecting ulna, radius and metacarpal bones

Question 23

how would you classify the location of this lesion: generalized, focal or multifocal

Answer 23

focal

Question 24

how would you classify the location of this lesion: generalized focal or multifocal

Answer 24

multifocal

Question 25

a bone lesion at the epiphysis is likely due to __ or __

Answer 25

infection, nutritional

Question 26

bone lesions in the metaphysis are typically ___ or __

Answer 26

primary neoplasia, infection

Question 27

based on the location of this lesion what are you concerned about

Answer 27

Primary bone tumor

Question 28

bone lesion in the diaphysis can be caused by what 3 things

Answer 28

1. Metastatic neoplasia- centered at nutrient form and 2. Secondary neoplasia- soft tissue mass with bone invasion 3. Focal infections- related to trauma

Question 29

based on the location of this bone lesion what are you concerned about

Answer 29

1. Metastatic neoplasia 2. Secondary neoplasia 3. Focal infections

Question 30

primary bone neoplasias are primarily in who

Answer 30

geriatric, large breed dogs

Question 31

soft tissue neoplasia typically has __centered around soft tissue. Usually more __ and crosses ___

Answer 31

swelling, lytic, joints

Question 32

what wrong here and what you concerned about

Answer 32

Lysis on patella, femur, patella displaced, soft tissue swelling Concern for soft tissue neoplasia

Question 33

metastatic neoplasia usually centered around ___in bone

Answer 33

nutrient foramen

Question 34

what tumor types typically cause metastatic spread to bone

Answer 34

carcinoma, sarcoma

Question 35

what type of disease are you concerned about

Answer 35

metastatic disease

Question 36

is Bacterial osteomyelitis typically focal or multifocal

Answer 36

focal

Question 37

how does bacterial osteomyelitis occur

Answer 37

trauma or hematogenous spread

Question 38

is fungal osteomyelitis focal or multifocal

Answer 38

multifocal

Question 39

what signalment typically gets fungal osteomyelitis

Answer 39

male, young, hunting dog

Question 40

what is more likely here: bacterial or fungal osteomyelitis

Answer 40

bacterial-focal

Question 41

what is more likely here- fungal or bacterial osteomyelitis

Answer 41

fungal-multifocal

Question 42

what wrong and what cause

Answer 42

fracture of humerus due to primary bone tumor