Soft tissue

Question 1

signs that a soft tissue swelling is benign (5)

Answer 1

<5cm
fluctuates in size
fatty/soft
cystic/fluid-filled
well-defined

Question 2

signs that a soft tissue swelling may be malignant (7)

Answer 2

lymphadenopathy
systemic features
irregular surface
sold
ill-defined
rapid growing
>5cm

Question 3

Ix to differentiate solid/cystic soft tissue swellings

Answer 3

US

Question 4

MRI is used if suspect a soft tissue swelling is __ and want more __

Answer 4

malignant

detail

Question 5

lipoma usually arise in __ or may be in ___

features =

Answer 5

S/C fat , muscle

fatty, painless, can be large, benign

Question 6

commonest hand swelling =

Answer 6

ganglion

Question 7

ganglion swelling has a __ outer and a ___ inner lining and they __
sites =
at DIPJ is called a ___

Answer 7

fibrous outer
synovial inner lining
transilluminate
hand wrist foot ankle knee
mucous cyst

Question 8

Rx for ganglion

Answer 8

excise only if painful

aspiration => 50% recurrence

Question 9

GCT arises from ___ is 2nd most common ___

Answer 9

synovium tendon sheath/joint

hand swelling

Question 10

GCT are ___ and have ___ deposition
sites = ++_
if painful Rx -

Answer 10

pigmented
haemosiderin
knee, toe and hand
excise (radio may help)

Question 11

PVNS aka 
similar to \_\_\_
arises from \_\_\_
\_\_+\_\_ types
commonest site = \_\_ may cause joint destruction and arthritis

Answer 11

Pigmented villonodlar synovitis
GCT
synovium
nodular and diffuse
knee

Question 12

Rx of PVNS

Answer 12

synovectomy

may be a knee replacement

Question 13

Baker’s cyst =

Answer 13

synovial fluid enters the semimebranous/medial gastroc bursa

Question 14

Baker’s cysts ___ in kids, in adults cause __/___

Answer 14

resolve

intra-articular pathology/arthritis

Question 15

Rx for Baker’s cyst

Answer 15

leave alone as high recurrence rate otherwise

Question 16

commonest 4 sites of bursitis

Answer 16

olecranon
pre + infrapatellar bursa
1st MT head (bunion)

Question 17

bunion =

Answer 17

1st MT head bursitis

Question 18

implantation dermoid progression =

___ trauma > ___ cells into __ > ___ with ___ and typical __ fluid

Answer 18

penetrating
epithelial
S/C
reactive cyst
greyish

Question 19

epidermoid/sebaceous cysts occur anywhere apart from __+__
___ cells go to ___ and line cyst secreting ___
usually have a __ connecting them to the epidermis

Answer 19

palms and soles
epithelial
S/C
keratin
punctum

Question 20

Rx for skin abscess -

Answer 20

incise and drain

Question 21

myositis ossificans = ___ ossification
trauma => ____ which ___ => __ around joints (usually ___)
on MRI can mimic ___

Answer 21

heterotrophic
intramuscular haematoma
calcifies
stiffness
painless
osteosarcoma

Question 22

Rx for myositis ossificans

Answer 22

can diminish over time
indomethacin can help
can excise when matured
radio post op/ prophylactically if have Sx and had it previously

Question 23

malignant soft tissue swellings = (6)

Answer 23

angiosarcoma
fibrosarcoma
malignant fibrous histiocytoma
liposarcoma
rhabdomyosarcoma
synovial sarcoma

Question 24

for malignant soft tissue swellings Ix =

Answer 24

MRI -> biopsy (wide local incision with radio usually)