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MSK final > musculoskeletal tumors > Flashcards

musculoskeletal tumors Flashcards

1
Q

benign x ray findings

A
  1. well defined, clear outline 2. surrounding rim of bone 3. not broken through the cortex 4. narrow zone of transition between lesion, normal bone
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2
Q

name 3 bone cancers

A
  • osteoid osteoma - osteosarcoma - osteochondroma all start with O!
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3
Q

name 2 cartilage cancers

A
  • enchondroma - chondrosarcoma
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4
Q

demographic of osteoid osteoma

A

usually patients under 20 or 25

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5
Q

benign cordial reaction with a radiolucent nidus

A

osteoid osteoma

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6
Q

location of osteoid osteoma

A

diaphysis

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7
Q

NSAIDs work in

A

osteoid osteoma

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8
Q

symptoms of osteoid osteoma

A

intense pain at rest/night in the long bone… no systemic symptoms

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9
Q

fever with osteoid osteoma?

A

no

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10
Q

osteosarcoma

A

soft tissue mass

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11
Q

associated with Rb

A

osteosarcoma

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12
Q

demographic of osteosarcoma

A

typically age 5-25, common in 10-20

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13
Q

may be secondary to Pagets disease

A

osteosarcoma

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14
Q

complications of Paget disease in the elderly

A

osteosarcoma and high output heart failure

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15
Q

imaging shows a mixed Lucent and dense “sunburst” lesion (also has ill defined borders)

A

osteosarcoma

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16
Q

pleomorphic cells producing osteoid

A

osteosarcoma

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17
Q

malignant osteoblast proliferation

A

osteosarcoma

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18
Q

Codmans angle

A

osteosarcoma

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19
Q

location of osteosarcoma

A

metaphyseal

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20
Q

usually grows away from the metaphysis

A

osteochondroma

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21
Q

demographic of osteochondroma

A

childhood

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22
Q

can be sessile or pedunculated

A

osteochondroma

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23
Q

multiple hereditary exostoses

A

multiple osteochondromas

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24
Q

inheritance pattern of multiple osteochondromas

A

autosomal dominant

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25
Q
A

Ewing sarcoma

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26
Q
A

osteoid osteoma

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27
Q
A
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28
Q
A

osteosarcoma

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29
Q
A

osteoid osteoma histology

30
Q
A

osteochondroma

31
Q
A

osteochondroma

32
Q

Very commonly seen in hand

A

enchondroma

33
Q
A

distal femoral enchondroma

34
Q

usually metaphyseal, central in bone

A

enchondroma

35
Q

age of enchondroma

A

>30 yrs

36
Q
A

enchondroma histology

37
Q

most common osseous hand tumor

A

enchondroma

38
Q

chondrosarcoma

A

Lytic changes

Cortical involvement

39
Q

“Bland”

No or very little atypia

Not very cellular; chondroid matrix

A

enchondroma histology

40
Q

Older patient population than most other primary bone tumors

A

chondrosarcoma

41
Q

age of chondrosarcoma

A

>50

42
Q

Chondroid tumors become more concerning as you move from ____ to ____

A

distal to proximal (pelvic, scapular lesions usually malignant; hand lesions almost always benign)

43
Q
A

chondrosarcoma

44
Q

Patient >50/60 with enlarging hip/pelvis/shoulder mass

A

chondrosarcoma

45
Q

simple unicameral bone cyst

describe it

A

Well-circumscribed

Central (not eccentric)

No matrix mineralization

Lucent

46
Q

demographic of Fibrous dysplasia

A

Wide age range, may first present in childhood

47
Q

can be associated with McCune Albright

  • café au lait, polyostotic FD, Endocrinopathy
A

Polyostotic fibrous dysplasia

48
Q

fibrous dysplasia on imaging

A

ground glass appearance

49
Q
A

fibrous dysplasia histology - Immature bony trabeculae (alphabet soup) with bland fibrous stroma

50
Q

giant cell tumor benign or malignant

A

benign

51
Q

demographic of giant cell tumor

A

age 30-50

52
Q

where does giant cell tumor occur

A

epiphysis at the ends of long bones

53
Q

Extends to subchondral surface (epiphyseal)

A

giant cell tumor

54
Q
A

Giant cell tumor

55
Q

contents of giant cell tumor

A
  • no matrix calcification
  • No reactive sclerosis or periosteal reaction
56
Q

Can occasionally be associated with fever, elevated ESR

A

Ewing sarcoma

57
Q

age of ewing sarcoma

A

10-30

58
Q

location of ewing sarcoma

A

diaphyseal or metaldiaphyseal

59
Q

cytogenetics of ewing sarcoma

A

11:22 translocation

60
Q

differential for new bony lesion in patient over 50

A
  • Metastatic disease
  • Myeloma
  • Lymphoma
61
Q

Often medullary but can compromise cortex

A

multiple myeloma

62
Q
A

multiple myeloma

  • radiolucent
  • punched out appearance
63
Q

carcinomas that tend to metastasize to bone

A

Lung (Lytic)

Breast (Lytic or Blastic)

Prostate (usually blastic)

Renal (Lytic)

Thyroid (Lytic)

Lead kettle: PBKTL

64
Q

Heterotopic bone formation in muscle

A

myositis ossificians

65
Q

location for Myositis ossificans

A

quadriceps

66
Q

Myositis ossificans can occur after

A

blunt trauma

67
Q
A

myositis ossificans

68
Q

paget disease can be associated with

A

osteosarcoma

69
Q

Usually, older patient (> 50 or 60), skeletal pain, bone bowing, elevated alk phos, possible high-output heart failure

A

paget disease

70
Q

metaphyseal bone tumors happen in these diseases

A

OGS

NOF

Enchondroma (finger–all bets are off)

Osteochondroma

Chondrosarcoma

Simple cyst

Mets

Myeloma

71
Q

disaphyseal bone tumors

A

Osteoid osteoma

Ewing’s sarcoma

Mets

Myeloma

MSK final (11 decks)

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