Pathology Flashcards by Sophie Baird

What are the features of an osteochondroma?

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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What are the features of an enchondroma?

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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What are the features of a simple bone cyst?

single cavity benign fluid cyst in bone
metaphyseal in long bones
cause weakness

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What are the features of an aneurysmal bone cyst?

lots of chambers
small arteriovenous malformation
metaphyseal
locally aggressive and painful
curettage and graft

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What are the features of a giant cell tumour?

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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What are the features of fibrous dysplasia?

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

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What are the features of an osteoid osteoma?

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

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Are malignant bone tumours common?

they are rare when primary but metastases are common to bone

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What are the symptoms of metastatic bone disease?

constant pain
worse at night
systemic symptoms

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What do malignant primary bone tumours look like on XR?

cortical destruction
periosteal reaction
new bone formation
extension into surrounding soft tissue

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What are the features of an osteosarcoma?

malignant
younger ages
spread to lungs
common and seen in knee

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What are the features of a chondrosarcoma?

cartilage producing
less common
older ages
large

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What are the features of a fibrosarcoma?

occur in abnormal bone and is in the young

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What are the primary malignant tumours that metastasise to bone?

breast
prostate
lung
renal cell
thyroid

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What are the features of soft tissue tumours?

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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What is the most common benign soft tissue tumour?

lipoma of fat

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What is a ganglion cyst?

around synovial joint
from weak point
well-defined and firm
usually around the wrist

What is bursitis?

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

What are the features of an AVN?

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

What surrounds the whole muscle?

epimysium

What surrounds a single fascicle?

perimysium

What surrounds a single muscle fibre?

endomysium

What is the autoimmunity pathway?

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

What type of genes are involved in autoimmune disease?

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

What are the most common causes for elective surgery?

- arthritis - soft tissue inflammatory problems - deformity correction - nerve decompression - joint instability

What are the complications of an arthroplasty?

early local - infection - dislocation - leg length changes - bleeding early general - hypovolaemia - shock - MI - PE late local - infection - loosening - fracture - pseudotumour formation

What is an excision or resection arthroplasty?

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

What is arthrodesis?

stiffening or fusion of a joint | this is good for ankle, wrist and 1st MTP joint arthritis

What is an osteotomy?

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

What are the features of soft tissue problems?

- 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

What are the causes of instability of a joint?

- injury - ligament laxity - anatomical variation - underlying disease

How are joint instability problems managed?

- physio - braces - surgery for ligament tightening, ligament reconstruction or fusion

What are the features of cellulitis?

- 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

What are the features of abscesses?

- discreet collection of pus - erythema, pain, history of trauma - LET OUT THE PUS - rest, elevation, analgesia, splint and antibiotics

What are the features of septic arthritis?

- 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

What are ganglia?

- 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

What are the features of rheumatoid nodules?

- Rh factor postitive - histology is intense inflammatory changes - no response to DMARDs, excision if problematic

What are the nodes of the hands called in RA?

- Bouchard's = proximal, OA or RA | - Heberden's = distal, OA, more common

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

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

What are the features of Ewing's sarcoma?

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

What are the features of myositis ossificans?

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