MSK Chapter - Pictures

Answer 1

Codman triangle

from elevation of periosteum

Definitely associated with osteosarcoma, may be associated with other things

Answer 2

Onion skin appearance in bone

May be associated with ewing sarcoma, osteomyelitis, osteogenic sarcoma

Answer 3

Sunburst pattern on X-ray

Definitely associated with osteosarcoma, may be associated with other things

Answer 4

Soap bubble appearance - giant cell tumor

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Salt and pepper sign of the calvaria refers to multiple tiny hyperlucent areas in the skull vault caused by resorption of trabecular bone in hyperparathyroidism.

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Osteopetrosis

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Osteopetrosis

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Rickets

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Rickets

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Achondroplasia

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Heberden’s nodes - associated with osteoarthritis

Question 12

What disease?

Answer 12

Osteoarthritis

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Answer 13

Bouchard’s node - Osteoarthritis

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Answer 14

Baker’s cyst - associated with Rheumatoid arthritis

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Eburnation - associated with osteoarthritis

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Subchondral cyst - associated with osteoarthritis

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Osteophyte - association with osteoarthritis

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Answer 18

Tophus - gout

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Tophus

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Answer 20

Bamboo spine - ankylosing spondylitis

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Answer 21

Dactylitis -

Usually associated with psoriatic arthritis

Dactylitis can occur in seronegative arthropathies, such as psoriatic arthritis and ankylosing spondylitis, and in sickle-cell disease as result of a vasoocclusive crisis with bone infarcts, and in infectious conditions including tuberculosis and leprosy. In Reiter syndrome, sausage fingers occur due to synovitis.[2]

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Answer 22

Pencil in cup deformity - psoriatic arthritis

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Answer 23

Lupus pernio - associated with sarcoidosis -

Cutaneous lesions of sarcoidosis (lupus pernio). Red-to-purple indurated plaques and nodules affecting the nose and cheeks.

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Answer 24

Lupus pernio lesions are indurated and violaceous and range from a few small lesions to large lesions as in this patient

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Answer 25

Schaumann body - calcium and protein inclusion inside Langhans giant cells - associated with: ## Footnote - Sarcoid - Hypersensitivity pneumonitis - Berylliosis - Crohn's, TB (rarely)

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Answer 26

This cytoplasmic Schaumann body (arrow) is common in sarcoidosis but is nonspecific. - Sarcoidosis - Hypersensitivity pneumonitis - Berylliosis - Crohn's, TB (rarer)

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Answer 27

Asteroid body An asteroid body, is a microscopic finding seen within the giant cells of granulomas in diseases such as sarcoidosis and foreign body giant cellreactions.[1]

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Gottron papules - associated with dermatomyositis

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Heliotrope rash - dermatomyositis

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Answer 30

Shawl and face rash - dermatomyositis

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Answer 31

Shawl and face rash - dermatomyositis

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Mechanic's hands Polymyositis and dermatositis People with dermatomyositis or polymyositis may develop “mechanic's hands,” a roughening and cracking of the skin of the tips and sides of the fingers, resulting in irregular, dirty-appearing lines that resemble those of a manual laborer

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Myositis ossificans - metaplasia of skeletal muscle to bone following muscular trauma

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Scleroderma

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Swan neck deformity - RA

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Melasma / Chloasma - hyperpigmentation associated with pregnancy

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Ephelis - Freckle Ephelis: A form of freckle. A flat red or light-brown spot on the skin that typically appears during the sunny months and fades in the winter. They are most often found in people with light complexions and in some families, they are an hereditary (genetic) trait. The regular use of sunscreen during times of sun exposure helps to suppress the appearance of the ephelis-type freckle.

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Verrucae - warts caued by HPV

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Hairy leukoplakia Associated with EBV, occurs in HIV positive patients

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Pemphigus vulgaris - note the reticular net-like pattern

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Answer 41

Bullous pemphigoid immunohistohemistry - IgG antibody against hemidesmosomes Antibodies are below the epidermis

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Erythema multiforme - associated with infections, drugs, cancers, autoimmune disease. Presents with multiple types of lesions. Looks like targets with multiple rings and dusky center showing epithelial disruption.

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Actinic keratosis - this is the one that precedes squamous cell carcinoma

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Erythema nodosum Painful inflammatory lesions of subcutaneous fat on anterior shins Remember: The leper crone cooked the hissing sardines on the table in the street. Sarcoidosis Coccidiomycosis Histoplasmosis TB Strep infections Leprosy Crohn's

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Answer 45

Lichen planus Pruritic, purple, polygonal planar papules and plaques

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Answer 46

Wickham striae are whitish lines visible in the papules of lichen planus and other dermatoses, typically the macroscopic appearance of the histologic... You get wickham striae with lichen planus mucosal involvement

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Pityriasis rosea - herald patch followed days later by christmas tree distribution. Multiple plaques with collarette scale. Self resolving in 6-8 weeks.

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Keratin pearl (2) associated with squamous cell carcinoma

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Answer 49

Basal cell carcinoma - note the palisading at the margins

Question 50

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Answer 50

Wickham striae - lichen planus oral version, take 2