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My MSK > Pathology > Flashcards

Pathology Flashcards

1
Q

What are the features of an osteochondroma?

A
  • benign lesion from aberrant cartilage from perichondral ring
  • usually near knee
  • bony outgrowth which is on the external surface so is a hard lump
  • local pain
  • can be genetic
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2
Q

What are the features of an enchondroma?

A
  • usually metaphyseal cartilaginous tumour from failure of enchondral ossification
  • usually lucent
  • can cause fracture
  • can be scraped out and replaced with bone graft
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3
Q

What are the features of a simple bone cyst?

A
  • single cavity benign fluid cyst in bone
  • metaphyseal in long bones
  • cause weakness
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4
Q

What are the features of an aneurysmal bone cyst?

A
  • lots of chambers
  • small arteriovenous malformation
  • metaphyseal
  • locally aggressive and painful
  • curettage and graft
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5
Q

What are the features of a giant cell tumour?

A
  • locally aggressive
  • epiphyseal
  • around the knee or spine
  • painful and may cause fracture
  • multi-nucleate giant cells
  • soap bubble on XR
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6
Q

What are the features of fibrous dysplasia?

A
  • adolescents with genetic mutation so lesions of fibrotic tissue
  • one or many bones
  • stress fracture
  • angular deformaties
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7
Q

What are the features of an osteoid osteoma?

A
  • nidus of immature bone surrounded by intense sclerotic halo
  • adolescence
  • intense constant bone pain worse at night
  • use NSAIDs
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8
Q

Are malignant bone tumours common?

A

they are rare when primary but metastases are common to bone

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9
Q

What are the symptoms of metastatic bone disease?

A
  • constant pain
  • worse at night
  • systemic symptoms
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10
Q

What do malignant primary bone tumours look like on XR?

A
  • cortical destruction
  • periosteal reaction
  • new bone formation
  • extension into surrounding soft tissue
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11
Q

What are the features of an osteosarcoma?

A
  • malignant
  • younger ages
  • spread to lungs
  • common and seen in knee
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12
Q

What are the features of a chondrosarcoma?

A
  • cartilage producing
  • less common
  • older ages
  • large
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13
Q

What are the features of a fibrosarcoma?

A

occur in abnormal bone and is in the young

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14
Q

What are the primary malignant tumours that metastasise to bone?

A
  • breast
  • prostate
  • lung
  • renal cell
  • thyroid
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15
Q

What are the features of soft tissue tumours?

A
  • benign: small size, fluctuation is size, cystic lesion, well-defined lesions, fluid-filled
  • malignant: large, rapid growth, solid, ill-defined, irregular, lymphadenopathy, systemic upset
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16
Q

What is the most common benign soft tissue tumour?

A

lipoma of fat

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17
Q

What is a ganglion cyst?

A
  • around synovial joint
  • from weak point
  • well-defined and firm
  • usually around the wrist
18
Q

What is bursitis?

A

fluid-filled sac to stop friction becomes inflamed due to trauma and infection can cause abscess

19
Q

What are the features of an AVN?

A
  • can be second to NOF
  • can be idiopathic
  • alcoholism or steroid use
  • necrosis of bone leads to patchy sclerosis
20
Q

What surrounds the whole muscle?

A

epimysium

21
Q

What surrounds a single fascicle?

A

perimysium

22
Q

What surrounds a single muscle fibre?

A

endomysium

23
Q

What is the autoimmunity pathway?

A
  • genetic susceptibility
  • initiating event*
  • breakdown of self-tolerance and loss of immune regulation
  • activation of auto-reactive T and B cells
  • hypersensitivity reactions
  • autoimmune disease/phenomena
24
Q

What type of genes are involved in autoimmune disease?

A

HLA genes which are highly polymorphic so variants increase or decrease susceptibility

25
Q

What are the most common causes for elective surgery?

A
  • arthritis
  • soft tissue inflammatory problems
  • deformity correction
  • nerve decompression
  • joint instability
26
Q

What are the complications of an arthroplasty?

A

early local

  • infection
  • dislocation
  • leg length changes
  • bleeding

early general

  • hypovolaemia
  • shock
  • MI
  • PE

late local

  • infection
  • loosening
  • fracture
  • pseudotumour formation
27
Q

What is an excision or resection arthroplasty?

A

removal of bone and cartilage of one or both sides of a joint

28
Q

What is arthrodesis?

A

stiffening or fusion of a joint

this is good for ankle, wrist and 1st MTP joint arthritis

29
Q

What is an osteotomy?

A

surgical realignment for deformity correction or load redistribution so there is more weight load to an undisposed area

30
Q

What are the features of soft tissue problems?

A
  • usually settle with rest, analgesia and NSAIDs
  • sometimes surgical debridement or decompression can be useful
  • synovectomy for extensor tendons to prevent rupture
  • major tendon tears require splint age, surgical repair or tendon transfer
31
Q

What are the causes of instability of a joint?

A
  • injury
  • ligament laxity
  • anatomical variation
  • underlying disease
32
Q

How are joint instability problems managed?

A
  • physio
  • braces
  • surgery for ligament tightening, ligament reconstruction or fusion
33
Q

What are the features of cellulitis?

A
  • inflammation and infection of the soft tissues
  • generalised swellings
  • presents as pain, swelling and erythema
  • caused by Beta haemolytic strep or staph
  • treat with rest, elevation, analgesia, splint and penicillin
34
Q

What are the features of abscesses?

A
  • discreet collection of pus
  • erythema, pain, history of trauma
  • LET OUT THE PUS
  • rest, elevation, analgesia, splint and antibiotics
35
Q

What are the features of septic arthritis?

A
  • bacterial infection of the joint
  • this is an emergency
  • irreversible damage to hyaline articular cartilage
  • S. aureus, Strep, E.coli
  • acute monoarthropathy, decreased ROM, increased swelling, systemic upset
  • urgent surgical opening needed
36
Q

What are ganglia?

A
  • out-pouching of synovium lining, filled with fluid
  • round swellings, wrist, feet and knees
  • manage based on symptoms
  • eg Baker’s cyst which is in pop fossa, non-tender, OA association, painful rupture
37
Q

What are the features of rheumatoid nodules?

A
  • Rh factor postitive
  • histology is intense inflammatory changes
  • no response to DMARDs, excision if problematic
38
Q

What are the nodes of the hands called in RA?

A
  • Bouchard’s = proximal, OA or RA

- Heberden’s = distal, OA, more common

39
Q

What are the features of a giant cell tumour of the tendon sheath?

A
  • localised
  • benign
  • firm swelling on the volar wrist
  • only surgery if there is an issue and would be marginal excision
40
Q

What are the features of Ewing’s sarcoma?

A
  • primary malignant bone disease
  • 10-20 years
  • can mimic infection with the symptoms
  • poor prognosis
  • needs radio and chemo
41
Q

What are the features of myositis ossificans?

A
  • abnormal calcification of a muscle haematoma
  • trauma, soft swelling and hardness later
  • XR and MRI
  • observe and only do something if there is pain

My MSK (13 decks)

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