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Tumor Chart DX 2 > Radiological Findings Tumors Exam 3 > Flashcards

Radiological Findings Tumors Exam 3 Flashcards

1
Q

Giant cell tumor

Rx findings

A 
geographic
-eccentric
-metaphyseal-epiphyseal
-subarticular
-expansion/soap bubble/ purely lytic (lg holes)
Cortical thinning
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2
Q

Solitary osteochondrosarcoma

Rx findings

A

En face may appear dense cortical rim around an area of lucency

  • sessile base lesion may cause metaphyseal widening or appear as an asym bump
  • cortex and spongiosa blend imperceptibly w the host bone
  • growth is at an angle to the long axis and towards the midshaft
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3
Q

Hereditary multiple exostosis (HME) “diaphyseal achalsia”

Rx Findings

A
  • cortex and spongiosa contiguous with host bone
  • shortening of the 4th & 5th metcarpals
  • supernumerary fingers and toes
  • Madelung or bayonet deformity
  • disproportionate shortening of extremity
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4
Q

Simple/solitary/unicameral bone cyst

Rx Findings

A
  • metaphseal adj to growth plate
  • central, 2-3cm oval radiolucency w long axis parallel to host bone
  • may be loculated w endosteal scalloping
  • truncated cone appearance
  • “fallen fragment sign”—aunt minnie
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5
Q

Aneurysmal bone cyst

Rx findings

A
  • Purely lytic & eccentric
  • aggressive expansile ballooning lesion “soap bubbles”
  • rapid progression in 6 wks- 3 months
  • almost invisible thin cortex (CT)
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6
Q

Osteoblastoma

Rx findings

A
  • spinal lesions are usually radiolucent and expansile
  • long bones show a progressive expansile lesion that may rapidly increase in size in 25%, metaphyseal to diaphyseal

+/- matrix calcification

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7
Q

Osteoid osteoma

Rx findings

A
  • cortical*: nidus in cortex, fusiform cortical thickening with 1 cm radiolucent area in…
  • cancellous: may be difficult to identify with delay in dx of 4 mts- 5 yrs due to lil reactive sclerosis
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8
Q

Osteoma

Rx findings

A

-well circumscribed round extremely dense lesion ~2cm in size

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9
Q

Enchondroma

Rx findings

A
  • round/oval lucency with fine marginal line
  • endosteal scalloping
  • stippled or punctuate calcifications
  • possible cortical thinning and expansion
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10
Q

Enchondromatosis/Ollier’s

Rx findings

A

-multiple enchondromas

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11
Q

Hemangioma

Rx findings

A

Rad Spinal features:
-exaggerated vertical trabeculations: “accordion”/ “corduroy”/ “honeycomb”

  • posterior bulg of cortex
  • extraosseous extension beyond bony lesion causing cord compression
  • paravertebral soft-tissue extension
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12
Q

Chondroblastoma

Rx findings

A
  • round or oval eccentric lytic lesion of an epiphysis or apophysis 1-6 cm in diameter
  • well defined sclerotic margin

-lobulated in 50%
-irregular/
punctuate calcification in 25-50%

-periostitis along metaphysic in ~30-50%

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13
Q

Fibrous cortical defect

Rx findings

A
  • round lytic lesion 1-2 cm in diameter with a well defined sclerotic margin
  • oval and extending parallel to the long asix which could produce cortical thinning and expansion
  • may be multilocular
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14
Q

Nonossifying fibroma

Rx findings

A
  • multilocular ovoid along the long axis
  • lytic lesion ~2 cm in length
  • dense sclerotic border
  • endosteal scalloping + thinning +/- bulging
  • migrates toward diaphysis
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15
Q

Paget’s disease

Rx finding

A
  • Increase or decrease density
  • coarsened irregular trabecular patter
  • thickened cortex (internal & external)
  • subarticular to diaphysis
  • osseous deformity
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16
Q

Paget’s disease

Skull features

A
  • “osteoporosis circumscripta”-well defined lysis of the frontal and occipital regions
  • “cotton wool” appearance-areas of increased density in the skull
  • basilar invagination w/ foraminal encroachment
17
Q

Paget’s disease

Long bone features

A

-begins at the bone end (subarticular)
“candle flame/ blade of grass sign”- advancing edge of the lytic phase
-cortical thickening and irregular trabeculae
-bowing deformities

18
Q

Paget’s disease

Pelvic features

A
  • thickening of ilopectineal line & cortical lines of the pubic bones=”rim sign”
  • thickening of trabeculae
  • acetabular protrusion
19
Q

Paget’s disease

Spinal features

A
  • coarse vertical trabeculae
  • “picture frame vertebra”
  • “ivory vertebra”
  • pathological collapse
20
Q

Fibrous dysplasia

Rx findings

A
  • most medullary cavity lesions are lucent, loculated, or trabeculated with a thick rim of sclerosis “rind sign”
  • may cause thinning of the cortex and widening of the shaft
  • internal matrix is usually cloudy “ground glass appearance”
21
Q

Fibrous dysplasia

Skull features

A
  • often areas of increased density along the convexity and anterior fossa
  • unilateral overgrowth of the facial bone
  • expansion in skull bones and ribs
22
Q

Fibrosarcoma

Rx findings

A
  • can present as a well defined lucent bone lesion >5cm
  • may appear as an aggressive permeative patter of destruction
  • sparse periosteal reaction
  • lg soft tissue mass
  • sequestration of bone may be present
23
Q

Sacrococcygeal chordoma

Rx findings

A
  • presacral mass avg. 10cm extending superiorly and inferiorly
  • lytic midline change in sacrum and coccyx
  • smophorus calcification 50% on plain film and ~70% on CT
  • displacement of rectum and bladder
24
Q

Sphenooccipital chordoma

Rx findings

A
  • bone destruction ~90%: clivus> sella> petrous bone> orbit> floor of middle cranial fossa> foramen magnum
  • soft tissue extension into nasopharynx
  • calcification/bone fragments 20-70%
25
Q

Vertebral chordoma

Rx findings

A
  • cervical (C2)> lumbars> thoracic
  • total destruction of vertebra
  • variable extension into spinal canal
  • can violate disc space to involve adj bodies (common)
  • anterior soft tissue mass
26
Q

Solitary plasmocytoma

Rx findings

A
  • typically presents as soap bubbly, highly expansile lesion
  • Sparing of the posterior elements
  • 70% will develop into diffuse form

Radiographic features

  • conventional radiography
  • bone scans may be normal
  • MRI examination sensitive for marrow changes
  • osteoporosis
  • osteolytic defects “rain drop skull”
  • osteoblastic lesions in
27
Q

Osteosarcoma

Rx findings

A

Comes in various forms: central (medullary canal), parosteal (2nd mc), secondary (>60 y/o) multcentric (rare), extraosseous (increase soft tissue, telangenstatic)

Radiographic

  • ill defined dense ivory or sclerotic lesion >5 cm filling medullary space
  • moth-eaten medullary & cortical destruction is less common
  • sunburst periosteal reaction/Codman’s
  • lg soft tissue mass w/ tumor new
28
Q

Chondrosarcoma

rx findings

A

round or oval area of demineralization with ill defined margins

  • endosteal scalloping from pressure erosion
  • popcorn matrix calcification in 2/3 with 1/3 being purely lytic
  • large soft tissue mass
29
Q

Ewing’s Sarcoma

Rx findings

A
  • 8-10 cm long lytic lesion in shaft of long bone (62% lytic, 23% mixed, 15% dense)
  • moth-eaten to permeative lesion (72%) as a late findings
  • “onion-skin” periosteal rxn (53%)
  • cortical saucerization
  • soft tissue mass formation in ~55%
  • Skeletal metastasis

Tumor Chart DX 2 (8 decks)

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