Multiple Lucent Bone Lesions Flashcards

1
Q

Ddx for multiple lucent bone lesions (Mnemonic “Metastases may eventually fracture bones”)

A

Metastases
Myeloma
Enchondromatosis (Ollier’s Disease/Mafucci Syndrome)
Fibrous Dysplasia
Brown tumors

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2
Q

Metastases

A

Generally occurs in those aged >40 years old
Variable appearances
Well or ill-defined but look for aggressive features
Non-expansile or expansile
May have a sclerotic component

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3
Q

Multiple Myeloma

A

Occurs in those aged >35 years old
Well-defined lytic lesions of uniform size
Endosteal scalloping (non-specific)
Rarely sclerotic

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4
Q

Enchondromatosis

A

Present in childhood
Commonly in hands and wrists
Multiple lytic, expansile, metaphyseal lesions
Chondroid matrix (punctate/curvilinear foci of calcification within lesion)
Abnormal growth, shortening and deformity of affected limbs

Ollier’s disease: many enchondromata

Mafucci’s syndrome: many enchondromata associated with soft tissue
haemangiomas (phleboliths seen on plain film)

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5
Q

Fibrous Dysplasia

A

Occurs in those aged <30 years old
Especially ribs, pelvis and proximal femur, humerus, skull and mandible
Diaphyseal or metaphyseal
Usually well defined
Endosteal scalloping
Hazy, ground-glass internal matrix
Thick sclerotic rim (“rind” sign)
“Shepherd’s crook” deformity – bowed proximal femur

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6
Q

Brown Tumors

A
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