Part 11 Flashcards
cause of giant cell tumor
neoplasm from non-bone formin supporting connective tissue of marrow
location of GCT
long bones
what is the most common benign tumor in the sacrum?
GCT
findings for GCT
geographic, eccentric, metaphyseal subarticular expansion soap bubble or purely lytic cortical thinning
age/gender of GCT
20-40
male
clinical features of GCT
localized pain (aching) restricted joint motion
treatment/prognosis of GCT
10% 5 year survival if malignant
surgical curretage with liquid nitrogen freezing
bone packing or grafting
recurrence rate of 12-50%
cause of solitary osteochondroma
unknown
displaced cartilage from the physis
location of solitary osteocondrooma
femur and tibia (metaphysis)
flat bones
bones with enchondral ossification
age/gender of solitary osteochondroma
<20
male
findings for solitary osteochondroma
cortex and spongiosa blend with host bone
growth at angle toward midshaft
coathanger exostosis
clinical features of solitary osteochondroma
asymptomatic MC unless they disturb nerves or vessels painless hard mass pain from fracture cord compression with spinal lesions obstructive uropathy from pelvic tumor pain and new growth may be malignant
treatment/prognosis of solitary osteochondroma
remove if affecting patient
otherwise leave it alone
cause of hereditary multiple exostosis
inherited autosomal dominant
location of hereditary multiple exostosis
metaphysis of long bones
multiple, bilateral
age/gender for hereditary multiple exostosis
2-10
male
findings for hereditary multiple exostosis
cortex and spongiosa continuous with host bone short 4th & 5th metacarpals supernumary fingers and toes madelung/bayonnet deformity disproportionate shortening of extremity
clinical for hereditary multiple exostosis
few to 100, average of 10
painless hard masses around joint
cord compression of obsrctive uropathy possible
5-20% malignant transformation
treatment/prognosis of hereditary multiple exostosis
remove if affecting patient
otherwise leave alone
cause of a solitary bone cyst
non-neoplastic fluid filled cavity lined with fibrous tissues
location of solitary bone cyst
proximal humerus
femur, talus
fibula, calcaneal neck
age/gender of solitary bone cyst
3-14
male
findings of solitary bone cyst
metaphyseal adjacent to grwoth plate central oval radiolucency, long axis parallel to host bone endoseal scalloping truncated cone appearance fallen fragment sign
clinical of solitary bone cyst
asymptomatic unless fractured
treatment/prognosis of solitary bone cyst
spontaneous regression in some
surgical curettage and bone chip
recurrence rate of 30-40%
most effective treatment is injection of steroids
cause of aneurysmal bone cyst
non-neoplastic expansile lesion containing thin-walled, blood filled cystic cavities
location of ABC
spine (neural arch)
long bones
flat bones
age/gender of ABC
10-30 (20 average)
female
findings of ABC
lytic and eccentric metaphysis
expansile ballooning lesion
rapid progression of 6 weeks to 3 months
almost invisible thin cortex
clinical of ABC
acute onset of pain with increased severity over 6-12 weeks
history of trauma
neurologic with spinal involvement
pathologic fractures
treatment/prognosis of ABC
surgical curretage and bone chip therapy with possible recurrance
radiation therapy may be used for some lesions, especially in the spine
cause of osteoblastoma
rare benign growth with unlimited growth potential
location of osteoblastoma
spine (posterior arches)
long bones
small bones of hands and feet
age/gender of osteoblastoma
10-20
male
findings of osteoblastoma
resembles osteoid osteoma, except >2cm
radiolucent and expansile
osteoid matrix
long bones (progressive expansile lesion)
clinical of osteoblastoma
dull pain with insidious onset, worse at night
painful scoliosis
treatment/prognosis of osteoblastoma
small lesions treated by excision or curettage
~5% recurrence rate
spinal lesions undergo radiation
cause of osteoid osteoma
benign skeletal lesion composed of osteoid and woven bone
location of osteoid osteoma
metaphysis/diaphysis of long bones
spine (posterior elements of lower thoracics and upper lumbars
painful scoliosis
age/gender of osteoid osteoma
10-25
male
findings of osteoid osteoma
radiolucent nidus <1cm
cortical: nidus in cortex, fusiform coritcal thickening with 1 cm radiolucent area
cancellous: may be difficult to identify with delay index of 4months-5 years due to little reactive scoliosis
clinical of osteoid osteoma
tender to touch and pressure
local pain weeks to years, worse at night, decreased by activity
salicylates relieve pain in 75-90%
labs of osteoid osteoma
bone scan (double density sign) CT: precise location of nidus angiography: nidus with intense circumscribed blush in early arterial phase
treatment/prognosis of osteoid osteoma
complete surgical excision of nidus
little change of recurrence
vertebral body lesions may be irradiated
cause of osteoma
membranous bone creating a benign tumor
location of osteoma
paranasal sinuses
inner/outer table of calvarium
may be mandible or nasal bones
findings of osteoma
well circumscribed round extremity dense lesion
~2cm in size
clinical of osteoma
associated with Gardner’s syndrome
