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Systems Path 1 > Musculoskeletal disorders Pt. III > Flashcards

Musculoskeletal disorders Pt. III Flashcards

1
Q

How much of lyme arthritis cases go untreated in the US?

A

60-80%

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2
Q

What organs are affected by lyme arthritis and what are the general symptoms?

A

Multiple organs. Fever, lymphadenopathy.

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3
Q

What kind of lesion is associated with lyme arthritis?

A

Erythema chronicum migrans

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4
Q

What is the Dx for lyme arthritis?

A

IgG and IgM in serum

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5
Q

What happens in later stages of lyme arthritis?

A

Joint destruction, migratory joint pain

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6
Q

What are the 3 stages of lyme arthritis?

A

Spirochete multiplication
Early dissemination
Late dissemination (2-3 years after infxn)

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7
Q

What are two phenomenon associated with the late dissemination phase of lyme arthritis?

A

A. Chronic polyarthritis: knee, shoulder, elbow, ankle

B. Encephalitis: mild-to-severe

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8
Q

What are examples of SOLs (4)

A

Blood, pus, tumor, edema

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9
Q

T/F

With SOLs primary joint neoplasms are rare

A

True

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10
Q

What is the definition of cyst?

A

epithelium-lined cavity in the body, containing

liquid or semisolid material*

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11
Q

What are some SOL tumor-like lesions?

A

Ganglion

Synovial cyst

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12
Q

What kind of cyst is a ganglion cyst?

A

Small myxoid cyst. Degenerative connective tissue

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13
Q

Where are ganglion cysts found?

A

Wrist: joint capsule/tendon space`

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14
Q

What is the tx for ganglion cysts?

A

compression, aspiration, “Bible therapy”

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15
Q

What is a synovial cyst?

A

Benign, synovial herniation through joint capsule

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16
Q

What are Baker’s cysts?

A

Popliteal cysts

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17
Q

What are tenosynovial giant cell tumors (TGCT)

A

A group of benign synovial tumors (previously thought ot be reactive lesions)

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18
Q

What is a diffuse TGCT?

A

(pigmented villonodular synovitis) Large, nodular mass in the joint synovium. Pain, ↓ ROM, joint locking, edema. Possible erosion of surrounding soft or bony tissues

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19
Q

What is a localized TGCT?

A

(GCT of tendon sheath)
• Small, solitary, tendon sheath nodule (hand: wrist, fingers)
• Well-circumscribed/localized, painless mass

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20
Q

Where are diffuse TGCTs found?

A

Knee MC (80%), hip, ankle

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21
Q

What is considered “soft tissue”

A

Any non-epithelial tissue, excluding: bone,

cartilage, CNS, hematopoietic, lymphoid tissue, adipose, fibrous, muscle, vessels, PNS

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22
Q

Soft tissue tumors are MC benign except when they are found where?

A

In skeletal muscle

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23
Q

What is the MC location for a soft tissue tumor?

A

Thigh

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24
Q

When do soft tissue tumors have a worse diagnosis?

A

When they are deeper/larger

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25
Q

What are lipomas?

A

Benign tumor of adipocytes. MC soft tissue tumor of adults.

• Solitary, painless, mobile, slow growing

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26
Q

What is a liposarcoma?

A

Malignant tumor of adipocytes. • Deep soft tissues: retroperitoneum, thigh

• Variable aggressiveness, possible mets (lungs)

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27
Q

What is nodular faciitis

A

Nodular fasciitis: reactive fibroblastic mass

• Non-neoplastic, self-limited

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28
Q

What locations is nodular faciitis found and what are some features noted? What is the Dx?

A

Possibly painful, solitary, rapid growth, 10-15% trauma
• Adults, volar (palm-side) arm, chest, back

Excision is necessary if painful

29
Q

What is myocitis ossificans

A

Reactive, metaplastic bone

• Hard/painless mass, distinct borders

30
Q

Among whom is myocitis ossificans found and in what locations?

A
  • Proximal extremity muscles (MC)

* Adolescent athletes, 2° to trauma

31
Q

What is the primary differential Dx for myocitis ossificans?

A

Osteosarcoma (age, osteoblastic)

32
Q

What is fibromatosis?

A

Benign, but locally invasive fibroblastic proliferation

33
Q

What are the features of a fibromatosis?

A

Disfiguring, painful, commonly recur

34
Q

Where are superficial fibromatoses found and what are some conditions identified with it?

A

superficial fascia, deformation

• Dupuytren contracture, Peyronie disease - (MC: 40-70 yrs.)

35
Q

What are and where are deep fibromatoses found?

A

(desmoid tumors): MC abdominal

• Rarely outside abdomen

36
Q

What are some features of deep fibromatoses and what conditions are identified with it?

A
  • Aggressive, locally destructive, recur

* Gardner syndrome: multiple deep fibromatoses intestinal polyposis, osteomas

37
Q

What is the Tx for fibromatoses?

A

Watchful waiting, excision, chemo., irradiation

38
Q

What are fibrosarcomas?

A
  • Malignant, slow growing, but destructive

* Present for years prior to diagnosis

39
Q

Where are fibrosarcomas found and among which age group?

A 
Deep tissues
• Thigh, retroperitoneum, knee
Originates in fibrous tissue → invades bone
• Femur, tibia, mandible 
• Adults: 35-55 years old
40
Q

What are some features of fibrosarcomas?

A

Fibroblasts & anaplastic spindle cells

• Unencapsulated, infiltrative

41
Q

What cytological finding is indicative of fibrosarcomas?

A

Herringbone pattern

42
Q

What percent of fibrosarcomas have mets? What metastatic pathway does it prefer and where does it MC spread to?

A

25% have hematogenous mets: MC lungs

43
Q

T/F

Fibrosarcomas generally do not occur again after excision?

A

False

50% recur after excision

44
Q

T/F

Virtually all skeletal muscle tumors are malignant

A

True

45
Q

What areas are most prone to rhabdomyosarcomas?

A

Areas with little skeletal muscle
• Head/neck (40%), genitourinary (25%),
extremities (20%), trunk (7%)*

46
Q

What is the MC pediatric soft tissue sarcoma

A

Rhabdomyosarcoma

47
Q

T/F

Rhabdomyosarcomas have a highly regular/identifiable appearance?

A

False,

Highly variable appearance

48
Q

What kind of prognosis is generally found with cases of rhabdomyosarcomas?

A

2/3 are cured (adults: poor prognosis)

49
Q

Where is a leimyoma found and what are some features?

A

benign
• Common, well-circumscribed
• Anywhere with smooth muscle cells: Uterus (MC, “fibroids”), small bowel, esophagus

50
Q

What are leiomyosarcomas?

A

Malignant

• Adults females (MC), firm painless mass

51
Q

Where are leiomyosarcomas found?

A

Deep: extremities, retroperitoneum (IVC)

52
Q

What are some telling cytological characteristics with leiomyosarcomas?

A

Spindle cells, cigar-shaped nuclei

• Superficial/smaller = better prognosis

53
Q

What are synovial sarcomas and what age group is most susceptible?

A

Aggressive/invasive, painless mass

• Any age, MC between 20-40 years

54
Q

T/F

Synovial sarcomas MC are found in joints

A

False

The name is misleading. <10% are intra-articular

55
Q

Where are synovial sarcomas found?

A

Deep soft tissues, near larger extremity joints

• MC Knee: 60-70% of cases

56
Q

Where do synovial sarcomas tend to have mets to?

A

Lung, bone, lymph nodes

57
Q

What is the tx for synovial sarcomas?

A

Limb sparing surgery (like osetosarcomas) and chemo

58
Q

What is the MC congenital disorder of the limbs?

A

Syndactyly

59
Q

What kind of bone is most affected by osteoporosis

A

Spongy, trabecular bone

60
Q

What kind of appearance is Paget’s disease said to have?

A

“shaggy appearance”

61
Q

What 3 pathologies can present an ivory vertebra sign on imaging?

A

Prostate Cancer (metastatic)
Paget’s disease
Lymphoma

62
Q

What are some common features of hyperparathyroidism?

A 
Renal stones (MC), peptic ulcers,
pathologic, Fx, bowing of long bones
63
Q

Multiple hereditary osteochondromas increase the risk for what condition?

A

Increase sarcoma risk (<1%)

64
Q

What two conditions present with a ring of sclerosis “O ring sign”?

A

OO and chondroma

65
Q

Who is most at risk for developing a chondrosarcoma?

A

40-60 yr old male

66
Q

If a chondrosarcoma has an increased translucency on x-ray, what does this mean?

A

Increase risk of a high grade

67
Q

NOFs increase risk for what?

A

Fracture

68
Q

What mutations do all forms of Fibrodyslasia come from?

A

Spontaneous GNAS mutations

69
Q

What condition has upon histological examination will look like chinese writing?

A

Polyostotic fibrodysplasia

Systems Path 1 (9 decks)

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