Part 15 images

Question 1

Diagnosis?

Answer 1

Giant cell tumor

geographic, eccentric, metaphyseal, subarticular, soap bubble appearance, cortical thinning

Question 2

Diagnosis?

Answer 2

Solitary Bone Cyst

fallen fragment sign

metaphyseal adjacent to growth plate, central oval radiolucency, long axis parallel to host bone, endosteal scalloping, truncated cone appearance

Question 3

Diagnosis?

Answer 3

Aneurysmal bone cyst

lytic and eccentric metaphysis, expansile ballooning lesion, rapid progression of 6 weeks to 3 months, almost invisible cortex

Question 4

Diagnosis?

Answer 4

Osteoblastoma

radiolucent and expansile osteoid matrix

in long bones, progressive expansile lesion

Question 5

Diagnosis?

Answer 5

ostoid ostoma

radiolucent nidus <1cm, thick sclerotic area around the nidus

salicylates relieve pain

Question 6

Diagnosis?

Answer 6

Osteoma

well circumscribed round extremely dense lesion

Gardner’s syndrome

Question 7

Diagnosis?

Answer 7

Hemangioma

accentuated trabeculation with thin sclerotic endplates

Question 8

Diagnosis?

Answer 8

Chondroblastoma

round/oval eccentric lytic lesion of epiphyseis or apophysis 1-6cm in diameter, punctate calcifications, periostitis

Question 9

Diagnosis?

Answer 9

Fibrous xanthoma (non-ossifying fibroma)

eccentric and metaphyseal, multilocular ovoid lesion along axis, dense sclerotic border, endosteal scalloping, thinning and bulging migrates toward diaphysis

Question 10

Diagnosis?

Answer 10

fibrous cortical defect

round lytic lesion 1-2 cm in diameter with well defined sclerotic margin, eccentric and metaphyseal, oval and extending parallel to long axis which could produce cortical thinning and expansion, lytic or bubbly appearace, may be multilocular

Question 11

Sign? Diagnosis?

Answer 11

osteoporosis circumscripta

Paget’s disease

polyostotic and assymetric increase or decrease in density, coarsened irregular trabecular pattern, thickened cortex, bone expansion, subarticular to diaphysis, osseous deformity, pathologic fracture

stage 1(osteolytic/destructive), stage 2(mixed/combined), stage3(sclerotic/ivory), stage 4(malignancy)

Question 12

Diagnosis?

Answer 12

Fibrous dysplasia

most medullary cavity lesions are lucent, loculated or trabeculated with rim sign, may cause thickening of cortex and widening of shaft, ground glass appearance

Question 13

Diagnosis?

Answer 13

osteosarcoma

ill defined sclerotic/ivory lesion, moth eaten, permative, spiculated/sunburst periosteal reaction, large soft tissue mass with tumor new bone

Question 14

Diagnosis? (differential diagnosis?)

Answer 14

Chondrosarcoma (calcified medullary infarct, enchondroma)

round area of demineralization with ill defined margins, endosteal scalloping from pressure erosion, popcorn matrix calcification

Question 15

Solitary osteochondroma

Answer 15

coathanger exostosis

femur, tibia

Question 16

HME

Answer 16

Madelung deformity

long bones

Question 17

SBC

Answer 17

injection of steriods is best treatment

fallen fragment sign

proximal humerus

Question 18

ABC

Answer 18

long bones, pelvis

Question 19

osteoblastoma

Answer 19

painful scoliosis

posterior arch

Question 20

osteoid osteoma

Answer 20

NSAIDs relieve pain

long bones

Question 21

enchondromatossi

Answer 21

ollier’s

maffucci syndrome, hands and feet

Question 22

fibrous dysplasia

Answer 22

proximal femur

Question 23

osteosarcoma

Answer 23

sunburst/spiculated

tend to be taller than peers

proximal humerus

Question 24

osteoma

Answer 24

gardner’s syndrome

paranasal sinuses

Question 25

chondrosarcoma

Answer 25

proximal humerus

popcorn matrix

Question 26

ewing’s sarcoma

Answer 26

long bones

cortical saucerization, onion skinned appearance

Question 27

paget’s

Answer 27

candle flame, blade of grass deformity, osteoporosis circumscripta, picture frame appearance