ortho oncology Flashcards
what are the two types of metastasis ?
lytic or scclerotic
when is surgical excision of the benign tumor indicated ?
if thinning of the cortex is more than 50%
if there is mass effect on adjacent structures
what is the management of benign cysts ?
surgical curettage
what is the most common benign tumor ?
osteochondroma (extosis)
what does osteochondroma look like on X ray ?
pedunculated lesion arising from near physiss
cartilage cap
what is the management of osteochondroma ?
excision if symptomatic
what are the classic symptoms of osteoid osteoma ?
localised pain
worse at night
relieved by salicylates
which bones are most affected by osteoid osteoma ?
femur
tibia
spine
what is the treatment for osteoid osteoma ?
radiofrequency ablation
when should amputation be considered in malignant tumors ?
tumors with vascular or neurological invasion
how is reconstruction achieved in malignant tumor management ?
endoprosthetic replacement
if there is a tibial tumor what other method of reconstruction can be used ?
autograft - from the fibula
2 malignant tumors ?
osteosarcoma
ewing sarcoma
where is the most common affection of osteosarcoma ?
around the knee or the shoulder
what are the x ray findings associated with osteosarcoma ?
codman’s triangle
sunburst appearance
where does ewing sarcoma mainly happen ?
diaphysis of long bones
what are the x ray findings associated with ewing sarcoma ?
onion peel periosteal reaction
most common bone malignancy ?
metastatic bone disease
MBD
what is mirels score ?
for predicting if lesions is at risk of pathological fracture
score 1. 2. 3
site upper limb , lower limb, peritrochanteric
pain mild, moderate, functional
lesion blastic, mixed, lytic
size <1/3, 1/3 to 2/3, >2/3
consider prophylactic stabilization if above 8
