Radio - Neoplasia / Infection

Question 1

Bone production takes how long before significant mineral olpacity can be seen?

Answer 1

10-14 days

Question 2

What can be seen on radiographs after 5-7 days?

Answer 2

Decreased olpacity due to significant mineral loss from bone lysis/reabsorption

Question 3

Benign changes

Answer 3

Chronic, degenerative, slow

Question 4

Aggressive changes

Answer 4

Active, ongoing, rapid

Question 5

Most important component to assessing if a lesion is aggressive

Answer 5

Component productive or lytic - presence of lytic automatic aggressive

Question 6

Pattern of bone lysis

Answer 6

Presence of cortical destruction
Zone of transition
Periosteal reaction/proliforation
Active vs inactive
Immature vs chronic

Question 7

Short zone of transition

Answer 7

Walled off disease process
Edge of lesion is well demarkated
Sclerotic border indicates a benign process

Question 8

Long zone of transition

Answer 8

Body cannot contain process
No distinct boarders

Question 9

What type of bone tumor is less common?

Answer 9

Benign bone cyst

Question 10

Stages of bone lysis

Answer 10

Permeative
Moth-eaten
Geographic

Question 11

Appearance of permeative lysis stage

Answer 11

Pin point areas
Aggressive

Question 12

Moth eaten pattens of lysis

Answer 12

Moderate sized area
Aggressive

Question 13

Geographic patterns of lysis

Answer 13

Large area of lysis
Aggressive or benign

Question 14

Periosteal layers

Answer 14

Outer fibrous layer
Inner Cambrian layer (bone production)

Question 15

Stimulation of periosteum

Answer 15

Produce bone towards the cortex
Solid to process = benign
Pocketed appearance = aggressive

Question 16

Periosteal reaction types

Answer 16

Solid
Lamellar
Interrupted
Complex

Question 17

Solid reaction type

Answer 17

Smooth or palisading

Question 18

Lamellar reaction

Answer 18

Intermediate layered appearance
Indicates cyclic growth process

Question 19

Interrupted reaction

Answer 19

Spiculated appearance
Long thin spicules indicate more aggressive process than shorter thicker spicules

Question 20

Complex reaction

Answer 20

Sunburst or amorphous

Question 21

Sunburst reactions

Answer 21

Spicules radiate from a central point indicating a focal point where a tumor has broken from the cortex

Question 22

Amorphous reaction

Answer 22

Bone is formed disorganized
Process may destroy spicules of bone as they form

Question 23

Classifications for reactions

Answer 23

Level of aggression
Activity level
Duration

Question 24

Codmans triangle

Answer 24

Solid periosteal reaction seen at the edge of an aggressive reaction

Question 25

Activity level can be determined by what feature

Answer 25

How clear the edges of a lesion are, can they be outlined w a pencil or no?

Question 26

Olpacities role in reactions

Answer 26

The older the lesion the more opaque or bone like it becomes

Question 27

Primary bone tumors occur is which groups

Answer 27

Large breed dogs As young as 6m, typical 7Y More common in males

Question 28

Typical features of primary bone tumors

Answer 28

Aggressive characteristics Mono static Rarely crosses joints or breeches other bones Metaphyseal location

Question 29

Metaphyseal location w bone tumors

Answer 29

Away from elbow (prox hum & distal rad) Toward the stifle (prox tibia & distal femur) Distal tibial - proximal diaphysis

Question 30

Largest percent of bone tumor types

Answer 30

75% osteosarcoma

Question 31

Other possible tumor diagnosis

Answer 31

Chondrosarcoma Fibrosarcoma Hemangiosarcoma

Question 32

Metastatic bone disease

Answer 32

Poly or monostotic Diaphysis, flat bones Aggressive characteristics Neoplasms that metastasize to bone

Question 33

neoplasms that commonly metastasize to bone

Answer 33

Carcinoma (mammary, lung, liver, thyroid, urinary, prostate) Osteosarcoma - systematic disease 14% have full body met

Question 34

Fungal osteomyelitis

Answer 34

Aggressive characteristics Periosteal reaction is semi aggressive Lysis may extend through cortex Adjacent medullary sclerosis

Question 35

Common places for histoplasmosis

Answer 35

East US Spread to bone is rare

Question 36

Blastomycosis

Answer 36

Middle Atlantic, SE sates 30% of cases have bone involvement

Question 37

Most common fungal osteomyelitis

Answer 37

Coccidoidomycosis (coccidioides immitus) Mono static Dia or metaphysis Predominant proliferation Hilar lymphadenopathy

Question 38

Bacterial osteomyelitis juveniles

Answer 38

Epiphysis and metaphysis of long bones in animals w decreased immunity

Question 39

Bacterial osteomyelitis in adults

Answer 39

Often at site or injury or surgery, Will not occur spontaneously

Question 40

Radiograph appearance for bacterial osteomyelitis

Answer 40

Earliest stages = soft tissue swelling Reaction is typically solid, extends along shaft of diaphysis