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Differential Diagnoses > Osseous > Flashcards

Osseous Flashcards

1
Q

Generalized increased bone density (Non-peds)

A

Myelosclerosis, renal osteodystrophy, fluorosis, blastic mets, lymphoma, mastocytosis, Paget

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2
Q

Solitary sclerotic bone lesion

A 
Dev - bone island or FD
Neo - Mets, lymphoma, osteoma, osteoid osteoma, healed malignant lesion, promary bone sarcoma, Paget
Vas - bone infarct
Traumatic callus formation
Inf - Sclerosing OM of Garre
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3
Q

Multiple sclerotic bone lesion

A

Dev - FD, osteopoikilosis/striata, tuberous sclerosis

Neo - mets, lymphoma, mastocytosis, MM, Gardener syndrome, multifocal osteosarcoma, Paget

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4
Q

Bone sclerosis with periosteal reaction

A

Healing fracture with callus
Neo - Mets, lymphoma, osteoid osteoma, osteosarcoma, Ewing sarcoma, chondrosarcoma
Inf - OM, syphilis
Idio - Infantile cortical hyperostosis, Melorheosotosis

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5
Q

Solitary sclerotic lesion with central lucency

A

Neo - Osteoid osteoma, osteoblastoma

Inf - Brodie abscess, spyhilis, Yaw, TB

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6
Q

Osteolytic lesion with Skin involvement

A

Cong - NF, basal cell naevus syndrome, angiodysplasia

Acq - Scleroderma, RA, Gout, leprosy, syphylis, LCH, sarcoidosis, Mastocytosis, Pancreatitis with osteonecrosis

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7
Q

Osteoblastic lesions with skin involvement

A

Cong - Osteopoikilosis, gardner syndrome

Acq - Reactive arthritis, SAPHO, lymphoma, sarcoidosis

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8
Q

Mixed blastic/lytic with skin lesions

A

Gaucher disease, psoriatic arthritis, SAPHO, Reactive arthritis, Sarcoidosis

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9
Q

Coarse trabecular pattern

A

Paget, osteoporosis/malacia, hemoglobinopathies (Thalassemia, Gaucher), hemangioma

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10
Q

Lytic skeletal mets (Origin sites)

A

Lung carcinoma, breast, renal cell carcinoma, Wilm tumor, bladder transitional cell, reproductive, thyroid, rectocolon, adrenal, skin

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11
Q

Blastic skeletal mets (Origin sites)

A

Lung carcinoid, breast, testis, prostate, bladder (TCC), stomach, colon, neuroblastoma

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12
Q

Medullary based, well-defined, corticated lucent lesion

A

Geode, Healing lesion, Brodie abscess, SBC, enchondroma, chondroblastoma, FD

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13
Q

Medullary based, well-defined, NON-corticated lucent lesion

A

Mets, MM, EG, brown tumor, Enchondroma, chondroblastoma

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14
Q

Medullary based, ill-defined lesion

A

Mets, MM, OM, Lymphoma, osteosarcoma, Ewing sarcoma, central chondrosarcoma, Fibrosarcoma

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15
Q

Medullary based, well-defined, eccentric lytic lesion

A

GCT, ABC, enchondroma, NOF, chondromyxoid fibroma

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16
Q

Lucent expansive lesion

A

Benign - ABC, GCT, enchondroma
Malignant - Mets, plasmacytoma, lymphoma, fibrosarcoma, telangiectatic osteosarcoma
Other - FD, hemophilic pseudotumor, browns tumor, hydatid

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17
Q

Subarticular lucent bone lesion

A

Arth - OA, RA, CPPD, gout, hemophilia
Neo - Mets/MM, ABC, GCT, Chondroblastoma, PVNS
other - Post-traumatic, osteonecrosis, TB

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18
Q

Lucent bone lesion with calcium/bone

A

Neo - Mets (breast), cartilage tumors (enchondroma, chondroblastoma, CMF, chondrosarcoma), bone tumor (osteoid osteoma, osteosarcoma), fibrous tumor (MFH)
Other - FD, Paget, AVN, OM, EG, intraosseous lipoma

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19
Q

Moth-eaten/permeative in adults

A

Neo - Mets, MM, Leukemia, Ewing, lymphoms, osteosarcoma, chondrosarcoma,MFH, LCH
Inf - Acute OM

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20
Q

Regional osteopenia

A

Disuse, Sudeck atrophy, TOH, regional migratory osteoporosis

21
Q

Generalize osteopenia

A

Osteoporosis, osteomalacia, HPT, Diffuse infiltrative bone disease (MM or leukemia)

22
Q

Osteomalacia/Rickets

A

Vitamin D deficiency, renal disease (renal osteodystrophy, Fanconi), hepatic disease, anticonvulsants, Mimicors ( hypophosphotasia, metaphyseal chondrodysplasia)

23
Q

Hair on end periosteal reaction

A

Ewing, syphilis, infantile cortical hyperostosis

24
Q

Sunburst periosteal reaction

A

Osteosarcoma, Mets, Ewing, Hemangioma, meningioma, TB, tropical ulcer

25
Q

Codman triangle periosteal reaction

A

Aggressive malignant lesion or infection

26
Q

Bilateral symmetrical periosteal reaction in adults

A

HOA, pachydermoperiostitis, vascular insufficiency, thyroid acropathy, fluorosis, DISH

27
Q

Bilateral Asymmetrical periosteal reaction in adults

A

Mets, OM, reactive/Ps. A, Non-accidental injuries, bleeding diatheses, Hand-foot syndrome

28
Q

Cause of HOA

A

Pulmonary - Carcinoma, lymphoma, abscess, cystic fibrosis, mets
Pleural - fibroma, mesothelioma
Cyanotic congenital heart disease
GI - ulcerative collitis, Crohn disease, dysentry, lymphoma, Celiac, juvenile polyposis

29
Q

Exuberant callus formation

A

Steroid/cushing syndrome, neuropathic arthropathy, OI, NAI, renal osteodystrophy, MM

30
Q

Erosion of the medial metaphysis of the proximal humerus

A

Normal variant, leukemia, Gaucher disease, Hurler, Glycogen storage disease, HPT, RA, Neimann-Pick disease

31
Q

Erosion of the distal clavicle

A

RA, Post-trauma, MM, mets, HPT, CCD, pyknodysostosis

32
Q

Focal rib lesion (solitary or multiple)

A

Neo - Mets, MM, Chondrosarcoma, Askin tumor, benign (osteochondroma, enchondroma, LCH)
Non-neo - Healed rib fracture, FD, paget disease, brown tumor, OM

33
Q

Rib notching - inferior surface

A 
Coarctation of the aorta (4-8th rib)
Aortic thrombosis (lower ribs)
Subclavian obstruction (upper unilateral)
Pulmonary oligemia
SVC obstruction
Pulmonary and chest wall AVM
NF
34
Q

Rib notching - superior surface

A

Connective tissue - RA, SLE, scleroderma, Sjogren
HPT
Misc - NF, poliomyelitis, Marfan, OI, progeria

35
Q

Wide or thick ribs

A

Chronic anemia, FD, Paget, healed fracture, achondroplasia, MPS

36
Q

Madelung deformity

A

Idiopathic, dyschondrosteosis, diaphyseal aclasis, Turner syndrome, post-infective

37
Q

Common carpal coalition

A
  1. Triquetral-lunate
  2. Capitate-Hamate
  3. Trapezium-trapezoid
38
Q

Massive carpal coalition (proximal-distal row)

A

Acrocephalosyndactyly (Apert), Ellis-Van Creveld, Holt-Oram, Turner, symphalangism, acquired (RA, pyogenic, chronic TB, post-trauma/surgery)

39
Q

Short metacarpal/tarsal

A

Idiopathic, post-traumatic, post-AVN, Turner’s, Pseudohypoparathyroidism, Pseudo-pseudoHPT

40
Q

Arachnodactyly

A

Marfan, Homocystinuria

41
Q

Acro-osteolysis (tuft)

A

Scleroderma, Raynaud disease, Ps. A, thermal, trauma, Hperparathyroidism, Phenytoin toxicity

42
Q

Acro-osteolysis (mid-portion)

A

PVC, Hajdu Cheney, hyperparathyroidism

43
Q

Periarticular osteolysis

A

Ps. A, Erosive OA, hyperparathyroidism, Scleroderma, MCRH

44
Q

Poorly defined lytic lesion in the distal phalanges

A

OM, mets, MM, ABC, GCT, leprosy

45
Q

Well defined lytic lesion in the distal phalanges

A

Enchondroma, sarcoidosis, glomus tumor, FD, osteoid osteoma

46
Q

Fluid-fluid level in bone lesion

A

Benign - ABC, chondroblastoma, GCT, SBC, FD

Mal - Telangiectatic osteosarcoma, MFH, necrotic bone tumor

47
Q

Increased uptake on bone scan

A

Blastic mets, joint disease, Trauma, post-surgery, paget disease, Superscan, metabolic bone disease, infection

48
Q

Photopenia on bone scan

A

AVN, MM, lytic mets, leukemia, Spina hemangioma

Differential Diagnoses (12 decks)

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