MSK Bone Tumors Flashcards
Lodwick classification of bone destruction?
Type:
- 1: geographic
- 2: moth-eaten
- 3: permeative
Lodwick classification of bone destruction –> Type 1: geographic –> 3 subtypes?
- 1A: thin sclerotic margin –> almost always non-agg
- 1B: well-defined margin –> usu non-agg
- 1C: partially indistinct
Lodwick classification of bone destruction –> type 3: permeative –> can be seen with what conditions? (3)
- lymphoma
- leukemia
- Ewing sarcoma
bone lesion –> fluffy, cloud-like matrix –> what matrix type?
Osteoid
bone lesion –> ring&arc, popcorn-like matrix –> what matrix type?
Chondroid
bone lesion –> groundglass matrix –> what matrix type?
fibrous
what is fallen fragmt sign?
simple bone cyst –> path fx –> fx fragmt inside bone cyst
bone island (enostosis) –> bone scan?
normal
osteopoikilosis –> synd? (2)
AD:
- mult bone island
- keloid
what is osteopathia striata?
benign asympt dysplasia: long bone, flat pelvic bone –> linear bands of sclerosis
osteopathia striata –> bone scan?
normal
osteoma –> location?
cortex:
- skull
- frontal, ethmoid sinus
Gardner synd –> synd? (3)
AD:
- mult osteoma
- intestine polyps
- soft tissue –> desmoid tumor
melorheostosis –> imaging appearance?
cortex –> thick & irreg –> “candle-wax” appear
melorheostosis –> assoc soft tissue finding?
overlying scleroderma-like skin lesion
melorheostosis –> location?
unilat LE –> single sclerotome distribution
melorheostosis –> bone scan?
intense uptake
osteoid osteoma –> classic clinical presentation?
teen/YA –> night pain –> relieve by ASA
osteoid osteoma –> XR/CT appearance?
- lucent nidus –> surrounding sclerosis
- central calc
osteoid osteoma –> bone scan?
“double density” sign:
- nidus –> intense uptake
- sclerosis –> adj reactive uptake
osteoid osteoma –> tx?
- IR radiofreq ablation
- surgical curettage
- resect
what is osteoblastoma?
osteoid osteoma –> >2cm
differentiate: osteoid osteoma vs osteoblastoma –> clinical presentation?
osteoid osteoma:
- teen/YA
- pain
- relieve w ASA
osteoblastoma:
- teen/YA
- pain
- NOT relieve w ASA
osteoblastoma –> MC location?
spine –> post elements
YA –> spine post element –> lytic lesion –> ddx? (2)
- osteoblastoma
- aneurysmal bone cyst
osteoblastoma –> MC imaging appearance?
lucent lesion –> mineralized
2ary osteosarcoma –> etiology? (2)
- Paget dz
- radiation
osteosarcoma –> general imaging hallmarks? (4)
- bony destruct
- osteoid matrix
- agg periosteal rxn
- assoc ST mass
osteosarcoma –> 4 MC subtypes?
- # 1 conventional (intramedullary)
- telangiectatic
- parosteal
- periosteal
osteosarcoma –> conventional (intramedullary) subtype –> MC location?
knee –> metaphysis:
- femur
- tibia
osteosarcoma –> telangiectatic subtype –> can look like what bone lesion?
benign ABC
differentiate: telangiectatic osteosarcoma vs other osteosarcomes
telang: no matrix
other ostesarcomas: osteoid matrix
osteosarcoma –> parosteal subtype –> arise from what part of bone?
outer periosteum
osteosarcoma –> parosteal subtype –> MC location?
distal femoral metaphysis –> post aspect
osteosarcoma –> parosteal subtype –> imaging appearance?
cauliflower-like exophytic –> lucent line separate from cortex
osteosarcoma –> parosteal subtype –> epidemiology?
30s-40s
osteosarcoma –> least malig subtype
parosteal
osteosarcoma –> periosteal subtype –> arise from what part of bone?
inner periosteum
osteosarcoma –> periosteal subtype –> MC location?
femur/tibia –> diaphysis
osteosarcoma –> periosteal subtype –> epidemiology?
<20yo
osteosarcoma –> MC mets location? appearance?
lungs –> calcify
what is synovial osteo/chondromatosis?
non-neoplastic –> synovial metaplasia –> intra-articular cartilag nodules
synovial osteo/chondromatosis –> MC location?
knee
mult round intra-articular bodies –> ddx? (2)
- synovial chondromatosis
- OA –> intra-articular bodies
MRI –> mult intra-articular foci –> low signal –> ddx? (2)
- synovial chondromatosis –> ossified
- pigmented villonodular synovitis (PVNS)
what is enchondroma?
benign –> lesion of mature hyaline cartilage rests
enchondroma –> matrix?
long bone –> chondroid
hand –> no visible matrix –> lytic lesion
enchondroma –> ddx? (2)
- medullary bone infarct
- chondrosarcoma
enchondroma –> tx?
curettage
what is osteochondroma?
benign –> bone growth projecting outward –> cartilage-cap
osteochondroma –> location?
metaphysis –> grow away from epiphysis
osteochondroma –> key imaging finding?
cortex & medulla continuous w host bone
osteochondroma –> potenial comp?
malig transform –> chondrosarcoma
mult osteochondromas –> what condition?
familial osteochondromatosis (mult hereditary exostoses)
chondroblastoma –> age?
skeletally immature –> 5-25yo
chondroblastoma –> location?
- long vs flat bone?
- dia/meta/epi-physis?
- MC bone?
- centric vs eccentric?
- long bone –> epiphysis –> eccentric
- knee/prox humerus
chondroblastoma –> T2 signal?
T2 –> low-interm
most chondroid lesions –> T2 hyper
chondroblastoma –> tx?
- curettage
- cryosurg
- radiofreq ablation
chondroblastoma –> benign or malig?
benign
what is chondromyxoid fibroma?
very rare –> benign cartilage tumor
chondromyxoid fibroma –> location?
knee –> femur/tibia metaphysis –> ecc
chondromyxoid fibroma –> imaging appearance:
- XR
- MR
XR –> sclerotic margins
MR –> T2 hyper