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Skeletal Rad II > Test #2 > Flashcards

Test #2 Flashcards

1
Q

3rd M/C primary osseous malignancy. Characterized by the formation of cartilage.

A

Chondrosarcoma

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2
Q

Chondrosarcoma is the M/C primary malignant bone tumor of what locations?

A

Hand
Sternum
Scapula

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3
Q

Secondary chondrosarcoma’s are a result of malignant degeneration of what two tumors?

A

Enchondroma

Osteochondroma

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4
Q

What age group/gender are M/C’ly affected by chondrosarcomas?

A

40-60yoa, Males

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5
Q

What is the most frequent complaint assoc. w/ chondrosarcoma?

A

Dull pain w/ an avg duration of several years

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6
Q

M/C sites of chondrosarcoma?

A 
Distal femur (M/C)
Pelvis
Prox. humerus
Ribs, sternum
Scapula
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7
Q

Which part of the bone is chondrosarcoma usually found?

A

Usually metaphyseal but may be diaphyseal

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8
Q

What are the radiographic features of chondrosarcoma?

A

Well-marginated, expansile, osteolytic lesion
Cortex may be thick or thin
Punctate, flocculent, circular, ring-like matrix
Occasional periosteal response
May have endosteal scalloping

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9
Q

What are radiographic signs of an advanced chondrosarcoma?

A

Cortical destruction

Soft tissue mass demonstrating calcification

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10
Q

What is high grade vs. low grade differentiation of a chondrosarcoma based on?

A

Tumor margins
Cortical destruction
Patterns of calcification
Soft tissue involvement

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11
Q

What are complications assoc. w/ chondrosarcoma?

A

Slow growing w/ late metastasis hematogenously to the lungs

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12
Q

What is the ddx assoc w/ chondrosarcoma?

A

Prox. enchondroma

Giant-cell tumor if calcification is lacking

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13
Q

M/C benign skeletal growth. Cartilaginous-capped bony growth off the surface of the bone

A

Osteochondroma AKA Osteocartilaginous exostosis

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14
Q

How long does an osteochondroma grow?

A

Till maturity

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15
Q

What are the 3 types of presentations for an osteochondroma?

A

Solitary osteochondroma
Multiple osteochondromas
HME (Hereditary multiple exostosis)

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16
Q

What is the M/C age range for an onsteochondroma?

A

10-20 years of age

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17
Q

What is the M/C complaint w/ osteochondroma?

A

hard painless mass near a joint

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18
Q

What can osteochondroma degenerate to?

A

Chondrosarcoma

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19
Q

What are the M/C locations for osteochondroma?

A

Distal femur

Prox. tibia

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20
Q

Where is osteochondroma found in the long bones? Spine?

A

Metaphysis; Secondary centers of ossification

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21
Q

What are the M/C locations for a pedunculated osteochondroma?

A

Knee
Hip
Ankle

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22
Q

What type of osteochondroma is a osteocartilaginous cap on a long narrow stalk?

A

Pedunculated

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23
Q

What type of osteochondroma has a broad base w/ localized widening of shaft?

A

Sessile

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24
Q

What is it called when an osteochondroma points away from the joint?

A

Coat Hanger exostosis

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25
Q

What is diaphyseal aclasia AKA?

A

Hereditary Multiple Exostosis (HME)

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26
Q

What is Hereditary Multiple Exostosis?

A

Multiple osteochondromas mainly in the metaphysis

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27
Q

When is Hereditary Multiple Exostosis M/C’ly discovered?

A

b/w ages 2-10

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28
Q

What are characteristics of Hereditary Multiple Exostosis?

A

Hard, painless masses near joint
Bone deformity
Usually bilateral & symmetrical

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29
Q

What deformity is assoc. w/ Hereditary Multiple Exostosis?

A

Bayonet hand deformity

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30
Q

What are the characteristics of Bayonet Hand deformity?

A

Shortening of the ulna
Outward bowing of radius
Subluxation of radio-ulnar joint

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31
Q

Where is Hereditary Multiple Exostosis M/C’ly found?

A

Long bones especially of the lower extremity

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32
Q

This is a benign tumor of cartilage. Originates from a cartilage displaced from the epiphyseal plate

A

Enchondroma AKA Chondroma

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33
Q

What enchondroma locations have greater potential for malignant degeneration?

A

Lesions located near the axial skeleton

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34
Q

What are two cartilaginous tumors that tend to b/co malignant?

A

Enchondroma

Osteochondroma

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35
Q

When is the greatest incidence of enchondromas?

A

b/w 2nd & 5th decade

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36
Q

How is an enchondroma discovered typically?

A

After a path fx

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37
Q

What is the M/C site for enchondroma?

A

Short tubular bones of hands

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38
Q

What are the radiographic features of enchondromas?

A 
Well marginated geographic lesions
Thin or thick cortex
Endosteal scalloping
Often expansile
Matrix calcification
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39
Q

What are two characteristics that indicate a cartilaginous tumor?

A

Matrix calcification

Endosteal scalloping

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40
Q

Multiple enchondromatosis is AKA?

A

Ollier’s disease

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41
Q

What is multiple enchondromatosis (Ollier’s disease)?

A

Osseous dysplasia characterized by hypertrophic cartilage that hasn’t been resorbed or ossified normally

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42
Q

What age is multiple enchondromatosis (Ollier’s disease) typically found?

A

Before 10yrs of age

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43
Q

What are the s/s of multiple enchondromatosis (Ollier’s disease)?

A

Marked shortening of the extremities
Severe deformity, deforming masses
Facial asymmetry

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44
Q

What syndrome is assoc. w/ multiple enchondromatosis (Ollier’s disease)?

A

Maffucci syndrome

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45
Q

What are the characteristics of Maffucci syndrome?

A

Enchondromas

Cavernous hemangiomatosis

46
Q

Where is multiple enchondromatosis (Ollier’s disease) found?

A

In Metaphyses & shafts of tubular bones

47
Q

What are radiographic characteristics of multiple enchondromatosis (Ollier’s disease)?

A

Rounded or linear radiolucencies
Lesions are expansile w/ or w/o matrix calcification
Bone shortening & deformity d/t eccentric growth

48
Q

This is an uncommon bone tumor originating from chondroblasts in the epiphyseal cartilage plate

A

Chondroblastoma AKA Codman’s tumor

49
Q

What is the peak age range for a chondroblastoma?

A

10-25 yrs of age

50
Q

What are the s/s of a chondroblastoma?

A

Joint pain, tenderness, heat, swelling
Limitation of motion
Weakness, numbness, & muscle atrophy

51
Q

What are the M/C sites for a chondroblastoma?

A 
Distal femur
Prox. tibia
Upper humerus
Femoral head & greater trochanter
Distal tibia
52
Q

What are the radiographic signs of chondroblastoma?

A

Well demarcated, oval or round radiolucency
Most are eccentric & may expand the cortex
Matrix calcification on occasion
Thin, sharply demarcated sclerotic margin is characteristic

53
Q

Chondroblastoma can mimic what?

A

A subchondral cyst

54
Q

What are complications assoc. w/ a chondroblastoma?

A

Formation of secondary ABC

Malignant degeneration after radiation tx

55
Q

This is a primary malignant bone tumor that doesn’t form neoplastic osteoid or cartilage

A

Fibrosarcoma

56
Q

What are the two types of fibrosarcoma?

A

Medullary or central (M/C)

Periosteal

57
Q

What are the two M/C malignancies seen in Paget’s?

A

Osteosarcoma (M/C)

Fibrosarcoma

58
Q

What is the M/C age to see fibrosarcoma?

A

30-50yrs of age

59
Q

What is the chief complaint seen w/ fibrosarcoma?

A

Progressive local pain & swelling

60
Q

What may be the initial presentation of a fibrosarcoma?

A

Pathologic fx

61
Q

Where are the M/C locations to find a fibrosarcoma?

A

Longs bones in younger pts
Flat bones in older pts
50% occur around the knee

62
Q

What are radiographic signs of fibrosarcoma?

A

majority eccentric medullary lesions
metaphysis that may extend into epiphysis
Expanding osteolytic lesion
Cortical thinning w/ endosteal scalloping

63
Q

What is are two characteristic signs of fibrosarcoma?

A

Cortical disruption w/ large soft tissue mass

May see bone sequestration

64
Q

What is a complication of fibrosarcoma?

A

hematogenous metastasis to lungs & central skeleton

65
Q

What is the ddx for fibrosarcoma?

A

Giant cell tumor

66
Q

This is a common benign tumor arising from fibrous tissue

A

Non-ossifying fibroma

67
Q

What is the peak age range for a NOF?

A

8-20 (M>F); Pt < 10 FCD, Pt >10 NOF

68
Q

What are the S/S assoc w/ NOF?

A

Mostly asymptomatic
Large lesions often cause persistent pain
Path. fx may occur

69
Q

What is the M/C location for a NOF to occur?

A

Lower extremity (distal tibia/diametaphyseal)

70
Q

What does a NOF look like radiographicaly?

A

Eccentric, ovoid radiolucency

Long axis paralleling the long axis of the bone

71
Q

What is a fibrous cortical defect AKA?

A

Caffey’s defect
Subperiosteal cortical defect
Fibrous xanthoma

72
Q

Where does a FCD originate in the bone?

A

Periosteum of the metaphysis

73
Q

What is the peak age range for a FCD?

A

4-8 yrs of age (M>F)

74
Q

What is the M/C location for a FCD?

A

pos. med. aspect of the distal femoral metaphysis

75
Q

What is the radiographic features of a FCD?

A

Small, ovoid, cortical radiolucency
Avg. size is 1-2cm
Long axis parallels long axis of the bone
Lobulation or slight bulging of the cortex

76
Q

This is an uncommon, slow growing, midline tumor arising from remnants of the notochord

A

Chordoma

77
Q

What is the M/C age for chordoma?

A

30-70 yrs of age; M>F

78
Q

What symptoms are assoc w/ a chordoma that has a sacrococcygeal location?

A

Constipation
Urinary dysfunction
Perineal pain or numbness

79
Q

What symptoms are assoc w/ a chordoma that has a spheno-occipital location?

A 
Increased intracranial pressure
Headache
Pontine & bulbar s/s
Ocular disturbances
hemiparesis
Ataxia
80
Q

What is the M/C locations for a chordoma?

A

Sacrococcygeal
Clivus
Vertebrae

81
Q

What is unique about chordomas and joints?

A

They may cross joints

82
Q

What is the main ddx for chordoma?

A

Osteolytic metastasis

83
Q

This is a quasimalignant tumor that is derived from connective skeletal tissue. AKA osteoclastoma

A

Giant Cell Tumor

84
Q

Of the 4 non-malignant painful tumors, Giant cell tumor is the one least likely to involve what area of the body?

A

The spine

85
Q

What is the M/C age & gender affected by Giant cell?

A

20-40 yrs F>M (malignant ones are predominant in males)

86
Q

What are S/S assoc. w/ a Giant Cell?

A

Intermediate dull ache
Sometimes a palpable, tender mass
May affect contiguous joint
Path fx may develop

87
Q

What lab studies should be used to rule out a brown tumor from a Giant Cell?

A

Serum calcium
Serum phosphorus
Alkaline phosphatase

88
Q

What is the M/C location for a Giant Cell?

A

Distal femur
Prox. tibia
Distal radius
Sacrum (M/C spinal site)

89
Q

What is the M/C benign tumor of the sacrum?

A

Giant Cell tumor

90
Q

What is the M/C neoplasm of the patella?

A

Giant Cell tumor

91
Q

Where do malignant Giant Cell tumors tend to show up, especially if male?

A

Distal radius

92
Q

What is the classic appearance of giant cell?

A

Roundish, moderate-sized, expansile, radiolucent lesion extending to the subarticular surface

93
Q

What are the radiographic features of a Giant Cell tumor?

A

Margin fairly well defined
Cortex is expanded & thin
Typically no periosteal response
Cortex may be destroyed w/ soft tissue invasion

94
Q

What is the ddx for giant cell tumor?

A 
Metastatic disease (older pt)
Plasmacytoma
Fibrosarcoma
Chrondrosarcoma
ABC
95
Q

This is the M/C benign tumor of the spine. Benign tumor arising from newly formed blood vessels

A

Hemangioma

96
Q

What is the M/C type of hemangioma?

A

Cavernous

97
Q

What are the S/S assoc. w/ hemangioma?

A

Majority are asymptomatic
May complain of vague intermittent pain
Compression fx

98
Q

What are the M/C locations for a hemangioma?

A

Spine

Skull

99
Q

What are the M/C locations in the spine for hemangioma?

A

Lower thoracic

Upper lumbar

100
Q

What is the M/C bone in the skull for a hemangioma?

A

Frontal bone

101
Q

What is the radiographic appearance of a hemangioma?

A

Corduroy-cloth appearance in spine
Usually solitary
Sunburst or spoke-wheel appearance in the skull

102
Q

What is the ddx w/ hemangioma?

A

Pagets disease

Osteoporosis

103
Q

This is a fluid filled cyst w/ a fibrous wall

A

Simple Bone Cyst

104
Q

What is a SBC AKA?

A

Unicameral bone cyst
Solitary bone cyst
Juvenile bone cyst

105
Q

What are the 2 types of SBC?

A

Active: adjacent to growth plate
Latent: displaced away from growth plate

106
Q

What is the peak age affect w/ a SBC?

A

3-14 yrs of age (M>F)

107
Q

What is the M/C symptom of a SBC?

A

Path fx

108
Q

What are the M/C locations of a SBC?

A

Metaphysis of prox. humerus, prox. femur

Centrally located

109
Q

What is the classic appearance of a SBC?

A

Moderate to large expansile lesion broader at the metaphysis than at the diaphysis (truncated cone appearance)

110
Q

What sign is assoc. w/ a SBC?

A

Fallen fragment sign

Skeletal Rad II (5 decks)

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