Theme 10 - SOFT TISSUE, BONE AND JOINTS Flashcards
what is “soft tissue”?
supportive tissue of organs and lymphoid tissue e.g. fibrous, adipose, skeletal (bone) and PNS
mesodermal in origin
Soft tissue tumours names (benign)
Most of them are benign
Lipomas- fat tissue Fibromas- fibrous tissue Leiomyomas- smooth muscle Heamangiomas- blood vessel Lymphangiomas- lymphatics Neuromas- Peripheral nerves
Nature of malignant soft tissue tumours
Sarcomas
Account for 1% of malignancies
Blood spread (haematogenous) to liver and lung but can spread via lymph system but this is less common
What syndromes are associated with soft tissue tumours?
Neurofibromatosis Type 1- Neurofibroma
Gardner syndrome-Fibromatosis
Carney syndrome-
Myxoma, melanotic schwannoma
Turner syndrome - cystic hygroma
How can soft tissue tumours be diagnosed?
Ultrasound guided core biopsy
Wide excision
(by musculoskeletal radiologist)
Genetically:
Cytogenetics- culture of fresh tissue and karyotypic analysis
Molecular genetics-
FISH and PCR and RT-PCR
Where do bone tumours arise and what are they called?
Arise from bone and cartilage
Osteoma if benign and osteosarcomas if malignant
benign cartilage tumours are chondromas
osteochondromas are mixec cartilage and bone tumours
osteosarcomas are most seen in what type of patients and which body parts?
young age group - teens
presents mainly in the knee (60% of cases)
other bone tumours
Ewing’s sarcoma
Giant cell tumours - can be benign or malignant
metastatic bone tumours - where are the primary sites?
thyroid prostate kidney breast GI tract
Systemic Lupus Eryth. symptoms and associated co morbidities
Cutaneous- Butterfly rash is typical affecting the bridge of nose and the cheeks
Cardiac- cardiomegaly,
endocarditis
CNS- important cause for morbidity and mortality- convulsions, hemiplegia
Renal- 45% of patients, Nephrotic syndrome and glomerulonephritis
What is systemic sclerosis?
Vessel damage and inflammatory response
causes diffuse widespread cutaneous lesions
Has renal, cardiorespiratory and GI tract implications
Artharlgia and arthritis involvement too
What is polymyalgia rheumatica symptoms?
Stiffness, weakness, aching and pain in the muscles of neck, limb girdles and upper limbs.
What is polymyalgia rheumatica associated with?
giant cell arteritis-
affects occipital or facial arteries- pyrexia, headache and severe scalp pain
granulomatous chronic inflammation
What are the 2 main categories of muscle diseases?
Myopathy-
Muscle disease unrelated to any disorder of innervation or neuromuscular junction
Myositis-
muscle fibres and overlying skin are inflamed and damaged resulting in muscle weakness
Muscular dystrophy pathogenesis & aetiology
inherited disorder (heterogenous)
causing progressively severe muscle weakness
and wasting
Begins in childhood
