RADIOGRAPHIC CHANGES

Question 1

1)overall enlargement and
acropachy
-tuft sign
2)tuft and heel pad thickening
3)widened joint spaces
4)periostitismetatarsals
5)gracile phalanges
6)proliferative
enthesiopathy

Answer 1

acromegaly

Question 2

-medullary canal of the host bone and the lesion are
confluent
*see note

-2 types, pedunculated and
sessile

-calcification of cartilaginous cap occurs

Answer 2

osteochondroma

Question 3

fibrocartilage cap lacks cortical/medullary continuity w/

underlying bone dorsomedial aspect of distal phalanx

Answer 3

subungual exostosis

Question 4

geographic lytic lesion: grade A or B

eccentric lobulations
w/ endosteal scalloping (cortex expands around the
lesion)

calcifications in long bones

Answer 4

enchondroma

Question 5

eccentric, epiphyseal lesions

geographic A lesion (smooth, scalloped, lobulated)

stippled calcification

Answer 5

chondroblastoma

Question 6

oval, eccentric metaphyseal
geographic A lesion

assymetric cortical
expansion***
-bone blister

fine calcifications

lacks significant periosteal new bone formation

small tubular bones
central w/ fusiform
expansion 
-diaphyseal 
-calcaneus

Answer 6

chondromyxoid fibroma (CMF)

Question 7

disproportionate shortening of bones
(leg or forearm)

lesions similar to solitary
osteocohondroma

metaphyseal clusters

Answer 7

diaphyseal aclasis

Question 8

multiple lytic lesions of metaphysis and diaphysis

interference of growth plates leads to shortening of
bone

phalanges and metatarsals spare distal phalanges

Answer 8

enchondromatosis

ollier disease

Question 9

skeletal lesions and limb deformities like Oliers disease but more B/L ST component
hemangiomas have small clots that calcify leading to phleboliths

Answer 9

enchondromatosis

maffucci syndrome

Question 10

eccentric bubbly lucent lesion

metaphyseal to meta diaphyseal

longer than is wide, parallels long axis of
bone

Answer 10

fibrous cortical defect (fibroxanthoma)

Question 11

eccentric geographic
lesion 1A

metaphyseal to
meta diaphyseal

longitudinal growth
pattern

lobulated contours
w/ internal bubbly
appearance

if lesion >50% bone
diameter, fx likely

Answer 11

non-ossifying fibroma

Question 12

lytic lesion w/in cortex=nidus (no larger <1-1.5 cm)
*marrow edema

bony surface

Answer 12

osteoid osteoma

Question 13

centrally situated and symmetric geographic

lytic lesions, grade A (occasionally B) w/o trabeculation, occasionally multiocular

can have mild expansion of the cortex w/out periosteal reaction (rarely exceeds
width of growth plate)

fallen fragment

simple bone cysts of calcaneus

Answer 13

simple bone cyst

Question 14

geographic lytic lesion w/ a 1A
margin

eccentric metaphyseal

outer margin dependent on

growth rate
blow-out is stage dependent

Answer 14

aneurysmal bone cyst

Question 15

open physis (growth
plate) argues against diagnosis of GCT geographic grade
B/C lesion if caught early

eccentric expansile trabeculated periosteal rxn is
uncharacteristic

Answer 15

giant cell tumors