PATH 179 LO 2 part 2 Flashcards
What is benign bone tumor?
displace soft tissue, Bone expansion, intact cortex with sclerotic margin
What is another name for osteochondroma?
exostosis
What is osteochondroma?
benign projection of bone with a cartilaginous cap.
- Bone tumor
- Childhood or teens, most common in knee
What is the cause of osteochondroma?
develops from the epiphyseal plate and grows laterally; usually runs parallel to bone and points away from the nearest joint
What are the signs and symptoms of osteochondroma?
- soreness of adjacent muscles
- May be able to feel protuberance
What are the radiographic exams for osteochondroma?
- x-ray
- US
- MRI
What is the radiographic appearance of osteochondroma?
- expands locally thinning and scalloping of the cortex
- Stippled, speckled ring-like calcification
- Long axis of the tumor run parallel to the parent bne
What is the treatment of osteochondroma?
resection
What is enchondroma?
Slow growing benign tumors of cartilage that arise in the medullary canal (ectopic cartilaginous growth)
- Children, young adults affected
- Small bones of hands and feet
- Expands bone and causes thinning an endosteal scalloping
What are the signs and symptoms of enchondroma?
- Pain
- Enlargement of affected finger or limb
What are the radiographic exams for enchondroma?
- x-ray
- CT
- Nuc med
- MRI
What is the radiographic appearance of enchondroma?
- stippled, speckled, ring or arc like (as compared to rest of bone)
- Tumor expands, thins cortex and can cause pathologically fractures
What is the treatment of enchondroma?
resection
What is another name for giant cell tumor?
Osteoclastoma
Where is a giant cell tumor?
- typically arises of the end of the distal femur or proximal tibia, after epiphyseal closure
- Does NOT involve joint
What is the signs and symptoms of giant cell tumor?
- Pain
- Swelling
- Limitation of movement
What are the radiographic exams for giant cell tumor?
- x-rays
- CT
- MRI
What is the radiographic appearance for giant cell tumor?
- Begins as an eccentric lucent lesion in the metaphysis, extends into immediate subarticular cortex
- As the tumor expands toward the shaft it looks like multiple large bubbles separated by strips of bone
what is the treatment for giant cell tumor?
- resection of the tumor
- amputation may be necessary
What is osteoma?
- arise in the outer table of the skull, paranasal sinuses (especially frontal or ethmoid) and the mandible
- Incidental finding on x-ray
What are the signs and symptoms of osteomas?
usually asymptomatic
What is the radiographic exam for osteomas?
- x-ray
- CT
What is the radiographic appearance for osteomas?
well circumscribed, extremely dense, round lesion that are rarely over 2cm
What is osteoid osteoma?
- benign tumor of teens or young adults.
- Originate from osteoblastic cells and most often occur in the femur and tibia
What are the signs and symptoms of osteoid osteoma?
local pain at night dramatically relieved by aspirin
what are the radiographic exams for osteoid osteoma?
- x-ray
- CT
- MRI
What is the radiographic appearance for osteoid osteoma?
small round or oval with lucent center (nidus), surrounding by large, dense sclerosis zone of cortical thickening (less than 1.5 cm in size)
What is the treatment of osteoid osteoma?
- pain with aspirin
- Resection
What is simple bone cyst?
- fluid filled cyst with a wall of fibrous tissue
- Occurs in proximal humerus or femur at the metaphysis
What is the signs and symptoms of simple bone cyst?
- usually asymptomatic
- May cause fractures
What is radiographic exams for simple bone cyst?
- x-ray
- CT
- MRI
What is the radiographic appearance for simple bone cyst?
- appears as an expansile (capable of expanding) lucent lesion
- Thin rim of sclerosis, oval configuration, may cause cortical bone thinning
What is the treatment for simple bone cyst?
depends on size and location of cyst
What is aneurysmal bone cyst?
consists of numerous blood filled AV (arteriovenous communication)
What causes aneurysmal bone cyst?
caused by trauma
What is the signs and symptoms of aneurysmal bone cyst?
- Pain
- Swelling
- Pathological fractures
What is the radiographic exams for aneurysmal bone cyst?
- x-ray
- CT
- MRI
What is the radiographic appearance of aneurysmal bone cyst?
-cortex may be so thin that it is invisible - may be mistaken for a malignant bone tumor
What is the treatment for aneurysmal bone cyst?
resection performed if pain is too intense or worried about pathological fractures
What is malignant bone tumors?
- produce true soft tissue swelling and cortical bone erosion with poor or absent margin
- Extend into soft tissue via spiculations (finger like projections)
What is osteogenic sarcoma?
malignant bone tumor.
- Occurs at ends of long bones in the metaphysis (especially knee)
- Tumor consists of osteoblasts which produce osteoid and spicules of calcified bone
What is the signs and symptoms of osteogenic sarcoma?
- local pain
- swelling
- fever
- weight loss
- secondary anemia
What are the radiographic examinations for osteogenic sarcoma?
- x-ray of affected bone
- PA/LAT chest to rule out mets
- CT to identify pathology in flat bones
- MRI used to rule out skip lesions and evaluate progression
What are the radiographic apearance for osteogenic sarcoma?
- mixed destructive and sclerotic lesion
- soft tissue mass
- ‘Sun burst’ pattern - horizontal spicules
What is the treatment for osteogenic sarcoma?
- chemo
- Surgery
- ampuation may be required
What is chondrosarcoma?
malignant bone tumor
what causes chondrosarcoma?
- cartilaginous origin
- originate anew or pre-existing lesion (osteocondroma or endchondroma)
- Occur in long bones but may also occur in rub, scapula or vertebra
What are the signs and symptoms of chondrosarcoma?
- local pain
- swelling
- at first pain is dull and gradually intestifies
what are the radiographic exams for chondrosarcoma?
- x-ray
- CT
- MRI
What are the radiographic appearance for chondrosarcoma?
-bone destruction, punctate or amorphous calcification, endosteal scalloping, cortical destruction
What is the treatment for chondrosarcoma?
- surgical excision
- amputayion
What is Ewings sarcoma?
malignant bone tumor. Arises in the bone marrow of long bones
-Affects children and young adults peak incidence in midteens and rare in perons over 30
What are the signs and symptoms of ewings sarcoma?
- Main complaint is local pain, often for several months, increases in severity, tender soft tissue mass
- Appear sick and malaise, fever and increased white count (leukocytosis)
What are the radiographic exams of ewings sarcoma?
- x-ray of affected bone
- PA/LAT chest to rule out mets
- CT
- MRI used to rule out skip lesions and evaluate progresion
What is the radiographic apearance for ewing sarcoma?
- radiographic: ill-defined permeative area of bone destruction, involves large central portion of the shaft, underlying medullary destruction
- Associated with fusiform layered periosteal reaction (onion skin)
- Tumor cells spread into soft tissue
What is the treatment for ewing sarcoma?
- chemo
- surgery
- amputation may be required
What is multiple myeloma?
- widespread malignancy of plasma cells
- Associated with bone destruction, bone marrow failure, hypercalcemia, renal failure and recurrent infections
- Attacks intramedullary canal of the diaphysis
What are the signs and symptoms for multiple myeloma?
- Pain
- Fatigue
- Frequent infections
- Nausea
What are the radiographic exams for multiple myeloma?
- Skeletal survey
- Bone marrow biopsy
What is the radiographic appearance for multiple myeloma?
punched out lesions on lateral skull:
- Skeletal survey
- Destruction on bone marrow of plasma cells throughout flat bones
- Generalized skeletal deossifications simulating postmenopausal osteoporosis
- Spine: decreased density in bodies, compresson fracture
What is the treatment for multiple myeloma?
- chemo
- Radiation therapy
- Stem cell transplant
What is bone mets?
-most common malignant bone tumors
What causes bone mets?
- spreading by means of bloodstream, lymphatic vessels, or direct extension
- most common primary tumors are carcinomas of the breast, lung, prostate, kidney and thyroid
What are the metastatic spread sites for bone metastases?
bones containing red marrow (spine, pelvis, ribs, skull and proximal ends of humerus and femur)
What are the signs and symptoms of bone metastases?
- weight loss
- Fatigue
- Nausea
- Pain
- fever
what are the radiographic exams of bone metastases?
- skeletal survey
- CT
- MRI
- Chest x-ray
- Nuc med
- PET scan
What is the radiographic appearance for bone metastases?
- Osteolytic
- Osteoblastic/sclerotic
- Mixed (mottled appearance)
What are the radiographic exams for bone metastases?
- CT abd MRI demonstrate extent of disease process
- PET scan
What is the treatment for bone metastases?
- Chemo
- Radiation therapy if not many lesions
- If not many lesions then resection is possibility
- Palliative
Define fracture
a discontinuity of bone caused by mechanical force
What are signs and symptoms to fractures
- large body parts such as hip, femur, and knee: unable to weight bear
- Smaller body parts: point tenderness
what is the radiographic procedure for fractures?
- 2 projections taken at right angles in determining alignment and extent of fracture
- joint above and below injury site should be included because there may be dislocation
- Stress radiographs are used to determine ligamentous stability: (requires a physician or radiologist to apply stress)
What is the radiographic appearance of fractures/
- appear as radiolucent line
- may appear radiopaque of the fragments overlap
Where does an anterior dislocation of the shoulder go?
Towards the Coracoid (95%)
What is spondylolithesis?
a cleft with forward displacement of one body over another usually the level of L5
What is spondylolysis?
refers to a cleft in the pars interarticularis
What is spondylosis
simply refers to destruction of the spine
What are the sign and symptoms of spondylosis?
chronic back pain
What is the radiographic procedure for spondylosis?
- AP/LAT lumbar spine
- Obli. L-spine may be necessary if no displacement seen
What is a disk hernination?
the bursa bulges. Puts pressure on the spinal cord and can cause neurological symptoms.
what is the cause of disk herniation?
due to degeneration or trauma
