SR4-Benign Bone Tumors

Question 1

This tumor is named for it’s radiographic appearance-looks like a vascular aneurysm. It arises in pre-existing lesions (e.g. enchondroma)

Answer 1

Aneurysmal Bone Cyst (ABC)

Question 2

ABCs affect what age range?

Answer 2

10-30

Question 3

Do ABCs have a sclerotic rim?

Answer 3

NO

Question 4

One of the unique things about this bone tumor is that it can cross cartilage boundaries! (Epiphyseal plates, joint cartilage, discs)

Answer 4

ABC

Question 5

Spinal ABCs tend to affect the ____ (anterior/posterior) elements of a vertebra

Answer 5

Posterior

Question 6

List the DDXs for a missing pedicle (ALOAN)

Answer 6

Agenesis 
Lytic metastasis
Osteoblastoma
ABC
Neurofibroma

Question 7

This can be referred to as a “blow-out” tumor. Highly expansile

Answer 7

ABC

Question 8

This bone tumor is also called a Unicameral Bone Cyst

Answer 8

Simple Bone Cyst

Question 9

__-__% of simple bone cysts affect long bones, especially the humerus

Answer 9

90-95%

Question 10

What non-long bone is common for a simple bone cyst?

Answer 10

Calcaneus

Question 11

ABCs and simple bone cysts are considered geographic lesions, type 1__

Answer 11

B (non-sclerotic rim)

Question 12

Simple bone cysts commonly affect ages __-__ and are painless (until path fx)

Answer 12

3-20

Question 13

The _____ sign is common when a path fracture happens due to a simple bone cyst

Answer 13

Fallen fragment

Question 14

The most common benign bone tumor of the SPINE?

Answer 14

Hemangioma of Bone

Question 15

The most common benign bone tumor of the RIBS? (Also very common in proximal femur)

Answer 15

Fibrous Dysplasia

Question 16

The most common benign bone tumor OVERALL?

Answer 16

Osteochondroma

Question 17

The most common benign bone tumor of the HANDS/FEET?

Answer 17

Enchondroma

Question 18

This bone tumor demonstrates “corduroy cloth” appearance in the spine, and “radiating spoke” appearance in the skull

Answer 18

Hemangioma of Bone

Question 19

A hemangioma demonstrates a ___ signal on T1 images, and a ____ signal on T2 images

Answer 19

High, high

Question 20

This is one disorder in a spectrum of disorders known as Langerhans Cell Histiocytosis. Out of the 3, it has the BEST prognosis (monostotic bone involvement)

Answer 20

Eosinophilic Granuloma (EG)

Question 21

____ in a child is highly suggestive of eosinophilic granuloma

Answer 21

Vertebra plana

Question 22

Skull lesions with a _____ are highly suggestive of EG

Answer 22

Beveled edge

Question 23

Are hemangioma’s painful? Are eosinophilic granulomas?

Answer 23

No, yes

Question 24

In the skull, these lesions have a central “button” sequestrum on radiographs

Answer 24

Eosinophilic Granuloma

Question 25

List vertebra plana DDXs (MELT)

Answer 25

Mets/myeloma EG Lymphoma Tumor/TB

Question 26

This tumor is borderline between benign and malignant (quasi-malignant). Painful, 85% occur in long bones (50%) in knee region, 5% occur in spine (especially sacrum)

Answer 26

Giant Cell Tumor

Question 27

Giant cell tumors are geographic lesions, type 1__. They are also eccentric, soap-bubbly and grow up to the joint margin.

Answer 27

C (ill-defined)

Question 28

Giant cell tumors usually affect adults from age __-__

Answer 28

20-40

Question 29

A circumscribed focus of cortical (compact) bone within cancellous (trabecular) bone. Usually under 1cm in diameter. Incidental findings.

Answer 29

Bone island

Question 30

Bone islands are very common, especially in ____ and ____

Answer 30

Femoral neck, pelvis

Question 31

A bone island may have what’s called a ____ border (speculated edge)

Answer 31

Brush

Question 32

A bone island would be what color on T1 and T2 MRIs?

Answer 32

BLACK

Question 33

What type of metastasis might a bone island be mistaken for?

Answer 33

Blastic

Question 34

“Spotted bone disease”

Answer 34

Osteopoikilosis

Question 35

A benign growth made up of an abnormal mixture of cells and tissues normally found in the area of the body where the growth occurs.

Answer 35

Hamartoma

Question 36

A hamartoma in the skull?

Answer 36

Osteoma

Question 37

_____ syndrome is a triad of osteomas, skin lesions, and colon polyps

Answer 37

Gardner

Question 38

This is a small, vascular tumor that is PAINFUL (worse at night), and is dramatically relieved by NSAIDS (ibuprofen, aspirin)

Answer 38

Osteoid Osteoma

Question 39

Osteoid osteomas affect what age range?

Answer 39

10-25

Question 40

A small radiolucency is called a ____

Answer 40

Nidus

Question 41

Osteoid osteomas can look like a ____ lesion if they have a central calcification within the lucent nidus

Answer 41

“Target”

Question 42

T/F: it is common for osteoid osteomas to trigger solid reactive new bone formation (cortical) around the tumor

Answer 42

TRUE

Question 43

In osteoid osteomas, a procedure where a probe is inserted into the nidus and the tumor is heated to kill the cells is known as _____

Answer 43

Radiofrequency Ablation

Question 44

This tumor is a GIANT OSTEOID OSTEOMA, but is NOT dramatically relieved by NSAIDS

Answer 44

Osteoblastoma

Question 45

__% of osteoblastomas affect the spine (typically, posterior elements)

Answer 45

40%

Question 46

This is the most common benign bone tumor (overall) and develops in childhood prior to the closure of the epiphyseal plate

Answer 46

Osteochondroma

Question 47

Two types of osteochondroma: a ____ or flat-base, and a ____, or stalked

Answer 47

Sessile, pedunculated

Question 48

A pedunculated osteochondroma takes on the appearance of a _____ due to it pointing AWAY from the joint

Answer 48

Coat Hanger

Question 49

This type of osteochondroma has a broad base and can be called “Cauliflower exostosis”

Answer 49

Sessile

Question 50

The possibility of malignant change in a solitary (single) osteochondroma is about __%

Answer 50

<1%

Question 51

_______ is what it is called when there are multiple osteochondromas

Answer 51

Hereditary Multiple Exostosis (HME), OR Hereditary Multiple Osteochondromas (HMO)

Question 52

Widened femoral necks may be a radiographic sign of?

Answer 52

HME/HMO

Question 53

These bone tumors like the hands/feet and exhibit “popcorn” (punctate) calcification. They commonly cause path fx

Answer 53

Enchondroma

Question 54

Multiple enchondromas is called ___ disease

Answer 54

Ollier’s

Question 55

Ollier’s disease + soft tissue hemangiomas = ___ syndrome

Answer 55

Maffucci

Question 56

_____ is the most common malignancy that osteochondromas, or enchondromas turn into

Answer 56

Chondrosarcoma

Question 57

The only tumor to arise in the EPIPHYSIS (other arise in metaphysis) is?

Answer 57

Chondroblastoma

Question 58

About __% of chondroblastomas are around the knee

Answer 58

50%