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Bone Path II > Midterm > Flashcards

Midterm Flashcards

1
Q

Giants Cell Tumor:

  • Appearance/ Special Features:
  • Symptoms:
  • DDX:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Lytic. Subchondral Extension
  • Symptoms:
    Most produce pain/Swelling
  • DDX:
    Chondroblastoma

-Malignant Potential:
Quasimalignant (20% malig)

-Refer?:
Yes

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2
Q

Osteochondroma

  • Appearance/ Special Features:
  • Symptoms:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Exostosis. Cortex and Trabecular bone continuous with underlying bone.
  • Symptoms:
    None

-Malignant Potential:
1* Solitary
20* Multiple

-Refer?:
No

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3
Q

Hemangioma

  • Appearance/ Special Features:
  • Symptoms:
  • DDX:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Vertebrae: Vertical Striations
  • Symptoms:
    None
  • DDX:
    Pagets

-Malignant Potential:
None

-Refer?:
No

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4
Q

Osteoma

  • Appearance/ Special Features:
  • Symptoms:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Skull or sinus; opaque; surface
  • Symptoms:
    None

-Malignant Potential:
None

-Refer?:
No

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5
Q

Bone Island

  • Appearance/ Special Features:
  • Symptoms:
  • DDX:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Thorny/Brush border
  • Symptoms:
    None

-Malignant Potential:
None

-Refer?:
No

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6
Q

Osteoid Osteoma

  • Appearance/ Special Features:
  • Symptoms:
  • DDX:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Opaque with <1cm nidus
  • Symptoms:
    Pain relieved by asprin
  • DDX:
    Osteoblastoma, Brodie’s abscess

-Malignant Potential:
None

-Refer?:
Yes

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7
Q

Osteoblastoma

  • Appearance/ Special Features:
  • Symptoms:
  • DDX:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Lytic, expansile in spine; variable sclerosis in other locations.
  • Symptoms:
    Pain
- DDX:
Osteoid Osteoma (Bigger nidus= Osteoblastoma)

-Malignant Potential:
None

-Refer?:
Yes

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8
Q

Enchondroma

  • Appearance/ Special Features:
  • Symptoms:
  • DDX:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Lytic; calcification in 50%; common in phalanx
  • Symptoms:
    None
  • DDX:
    Chondrosarcoma if lesion is larger and closer to spine.

-Malignant Potential:
1* solitary
25-50* multiple

-Refer?:
No

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9
Q

Chondroblastoma

  • Appearance/ Special Features:
  • Symptoms:
  • DDX:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Epiphysis; calcification in 50%
  • Symptoms:
    None
  • DDX:
    GCT

-Malignant Potential:
None

-Refer?:
Yes

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10
Q

FCD: NOF

  • Appearance/ Special Features:
  • Symptoms:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Within cortex; eccentric, small, sclerotic margin
  • Symptoms:
    None

-Malignant Potential:
None

-Refer?:
No

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11
Q

Simple Bone Cyst

  • Appearance/ Special Features:
  • Symptoms:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Lytic, Central
  • Symptoms:
    None

-Malignant Potential:
None

-Refer?:
Yes

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12
Q

Aneurysmal Bone Cyst

  • Appearance/ Special Features:
  • Symptoms:
  • Malignant Potential:
  • Refer?:
A
  • Appearance/ Special Features:
    Expansile
  • Symptoms:
    Pain

-Malignant Potential:
None

-Refer?:
Yes

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13
Q

Painful lesion of posterior elements in younger patients

DDX:

A

Osteoid Osteoma (sclerotic)
Osteoblastoma (lytic)
Aneurysmal Bone Cyst (lytic)

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14
Q

DDX for sclerotic tumor with nidus.

A 
Oteoid Osteoma (<1cm Nidus)
Osteoblastoma (>2cm Nidus)
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15
Q

(T/F) All blastomas are painful and require referral.

A

True

  • Chondroblastoma
  • Osteoblastoma
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16
Q

DDX:

Lytic neoplasm of epiphysis

A

Giants Cell

Chondroblastoma

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17
Q

How do you tell Giant Cell Tumors from Chondroblastomas.

A

Chondroblastoma

  • Epiphysis before growth plate closes (young).
  • May have sclerotic margin
  • May have calcification

Giant Cell Tumor

  • After growth plate closure (20-40)
  • No calcification or sclerotic margin.
  • Mostly in metaphysis, but extends into epiphysis.
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18
Q

How do you differentiate between Giant Cell Tumor and Aneurysmal Bone Cyst.

A

Age mostly.
ABC= 5-20
Giant Cell= 20-40

19
Q

Benign Tumors that produce pain

A 
Osteoid Osteoma
Osteoblastoma
Chondroblastoma
Aneurysmal Bone Cyst
GCT (quasimalignant)
20
Q

Benign Tumors that DONT produce pain

A 
Osteochondroma
FCD/NOF
Simple Bone Cyst
Enchondroma
Hemangioma
Bone Island
Osteoma
21
Q

All benign tumors are <30 y.o except _

A 
Hemangioma (>40)
Bone Island (Any)
22
Q

Which Benign Tumors do you refer out?

A 
Osteoblastoma
Chondroblastoma
Osteoid Osteoma
Aneurysmal Bone Cyst
Simple Bone Cyst
GGT
23
Q

DDX Ivory Vertebra

A

Mets
Pagets
Lymphoma (least common)

24
Q

4 Most common Primary Malignancies of bone and their age groups

A

Multiple Myeloma (50-70)
Osteosarcoma (10-25)
Chondrosarcoma (40-60)
Ewings Sarcoma (10-25)

25
Q

DDX:
Large, Geographic, Lytic lesion of proximal femoral metaphysis extending into diaphysis. A thin sclerotic margin seen at the proximal margin of the lesion.

Refer?

A

Simple Bone Cyst
Enchondroma
NOF
Fibrous Dysplasia

Yes, refer incase of pathologic fx.

26
Q

Who do you refer to if there is a risk of a pathologic fracture in a solitary lesion?

A

Orthopedic surgeon.

27
Q

What are the benign lesions that are painful?

A 
Chondroblastoma
Osteoid osteoma
Osteoblastoma
Giant Cell Tumor
Aneurysmal Bone Cyst
28
Q

What benign tumors do you refer out?

A 
Chondroblastoma
Osteoid osteoma
Osteoblastoma
Giant Cell Tumor
Aneurysmal Bone Cyst
Simple Bone Cyst
29
Q

Aggressive Signs

A 
Cortical Destruction
Moth eaten or permeative lytic
Soft Tissue Mass
Aggressive Periosteal response
-Multiple Laters
-Spiculated
-Codman Triangle
Large
30
Q

Painful Scoliosis DDX

A

Osteoid Osteoma
ABC
Osteoblastoma

31
Q

Primary Malignancy between the age 10-20

DDX

A

Osteosarcoma

Ewing Sarcoma

32
Q

Primary malignancy between the age of 20-35

DDX

A

Hodgkin Lymphoma

33
Q

Labs to look for primary malignancy

A 
ESR
Serum Calcium (lytic)
Alkaline Phosphatase (blastic)
34
Q

Most common route for metastasis

A

Hematogenous (blood)

35
Q

Lab changes seen in Multiple Myeloma

A 
Anemia
Elevated ESR
Serum Proteins
Bence Jones proteins in urine
Rouleaux formation
36
Q

What is the big risk with Solitary Plasmacytoma?

A

70% develop multiple myeloma within 5 years

37
Q

Mets:

Age=
Appearance=
Location=

A

Age= 40+
Appearance= Multiple bones/lesions
Location=Axial skeleton

38
Q

Multiple Myeloma

Age/Location:
Diagnositic Criteria:

A

Age/Location: Same as mets

Diagnositic Criteria: Proteins

39
Q

Plasmacytoma

Solitary form of _
Age=
Appearance=

A

Solitary form of Multiple Myeloma

Age= Younger (not young)

Appearance= Lytic, Bubbly, Expansile.

40
Q

Primary malignancy in young that mimics infection

A

Ewings sarcoma

41
Q

Treatment for Pagets?

A

Reduce bone resorption with calcitonin
- Gives pain relief.

Supportive braces

42
Q

Deformities seen with Pagets

A 
Shepherds crook
Sabre Shin
Basilar Invagination
Protrusio Acetabuli
Leontiasis ossea
Genu Varum
43
Q

Most common complication of Pagets

A

Pathologic Fracture

44
Q 
Stages of Pagets
Stage 1:
Stage 2:
Stage 3:
Stage 4:
A

Stage 1: Osteolytic, destructive

Stage 2: Combined, mixed

Stage 3: Sclerotic, Ivory

Stage 4: Malignant degeneration (coarsened trabeculae, thickened cortex, bone expansion.

Bone Path II (5 decks)

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