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Musculoskeletal Physiopathology > Tumor Imaging and Cystic Lesions of Bone > Flashcards

Tumor Imaging and Cystic Lesions of Bone Flashcards

1
Q

When analyzing lesions, one must consider:

A
  • Age
  • Clinical presentation
  • Radiographic characteristics
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2
Q

L’PoDZ PMS

What are five radiographic characteristics to analyze a lesion?

A
  • Location
  • Pattern of destruction
  • Zone of transition
  • Periosteal reaction
  • Soft tissue mass
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3
Q

What are some descriptions for where in the bone a lesion has occurred?

A
  • Epiphysis/apophysis, metaphysis, diaphysis
  • Central (eucentric)/eccentric
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4
Q

What are the osteolytic patterns of destruction?

A
  • Permeative
  • Moth-eaten
  • Geographic
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5
Q

What are the osteoblastic patterns of destruction?

A
  • Focal
  • Multifocal
  • Diffuse
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6
Q

What is a permeative pattern of destruction?

A

Multiple endosteal radiolucent small lesions with a poor zone of transition
(osteolytic)

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7
Q

What is a moth-eaten pattern of destruction?

A

Multiple moderately sized endosteal radiolucent lesions with a poor zone of transition
(osteolytic)

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8
Q

What is a geographic pattern of destruction?

A

Lesion with sharply defined border and narrow zone of transition between normal and pathologic bone
(osteolytic)

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9
Q

What is a focal pattern of destruction?

A

Increased osteoblastic activity in one location appearing radiopaque

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10
Q

What is a multifocal pattern of destruction?

A

Multiple/many locations of increased osteoblastic activity appearing roadiopaque

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11
Q

What is a diffuse pattern of destruction?

A

Multiple bones (ie. spine, pelvis) increase in bone density (sclerotic) (without pinpoint locations of lesions)
(osteoblastic)

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12
Q

what is the zone of transition?

A

Interface between normal bone and diseased bone

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13
Q

How might the zone of transition be described?

A

Long or short; wide or narrow

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14
Q

If prostate cancer has caused the spine and pelvis to increase bone densities, what pattern of destruction has occurred?

A

Diffuse osteoblastic destruction

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15
Q

reactive bone formation

Intramembranous bone is formed in response to…

A

stress on bone or soft tissue

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16
Q

reactive bone formation

Once stimulus lifts the periosteum, what is the result?

A

Intramembranous bone formation

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17
Q

reactive bone formation

If the periosteum has lifted, which types of bone will be made during intramembranous bone formation?

A

Woven or lamellar

18
Q

What is the term for the process of lifting the periosteum and intramembranous bone formation?

A

Periosteal reaction

19
Q

What are the types of periosteal reaction?

A
  • Solid
  • Laminated
  • Spiculated
  • Codman’s triangle
20
Q

Can the periosteal reaction involve the endosteum?

A

Yes

21
Q

How does a solid periosteal reaction progress?

A
  • Slow growing
  • Typically non-aggressive
  • Periosteum is lifted slowly and fills completely
22
Q

A patient has experienced a fatigue fracture causing bone hemorrhage. Their radiographs now display a periosteal reaction that has filled completely.
What type of periosteal reaction has occurred?

A

Solid periosteal reaction

23
Q

A patient is known to have osteoid osteoma, a benign bone tumor. Their radiographs display a slow growing, filled in periosteal reaction.
What type of periosteal reaction has occurred?

A

Solid periosteal reaction

24
Q

What are some causes of solid periosteal reaction?

A
  • Bone hemorrhage (ie. fatigue fractures)
  • Benign bone tumors (ie. osteoid osteoma)
25
Q

Which periosteal reaction is an aggressive process of lifting, stopping, and lifting the periosteum again?

A

Laminated periosteal reaction

26
Q

What is a laminated periosteal reaction?

A
  • Aggressive process
  • Lifts periosteum, stops, lifts again, etc.
  • Lays down bone during rest phase
27
Q

Which periosteal reaction is an aggressive process where periosteum is lifted rapidly?

A

Spiculated periosteal reaction

28
Q

A patient’s radiograph evidences bone growth along Sharpey fibers with a “hair on end”/”sunburst” appearance
What type of periosteal reaction has occurred?

A

Spiculated periosteal reaction

29
Q

How does a spiculated periosteal reaction appear on a radiograph?

A
  • Bone growth along the Sharpey fibers
  • “Hair on end”/”sunburst” appearance
30
Q

Which periosteal reaction is an aggressive process extending beyond bone (into unaffected bone) rapidly?

A

Codman triangle periosteal reaction

31
Q

What is Codman triangle periosteal reaction?

A
  • Aggressive pattern
  • Extends beyond bone rapidly
  • Strips periosteum away from adjacent uninvolved bone
32
Q

What are five patterns of matrix calcification?

A
  1. No calcification (can’t tell on purely lytic lesions)
  2. Target calcification
  3. Stippled calcification
  4. Blastic lesion
  5. Ground glass
33
Q

Which matrix calcification occurs in fat?

A

Target calcification

34
Q

Which matrix calcification occurs in cartilage?

A

Stippled calcification

35
Q

Which matrix calcification occurs in osseous tissue?

A

Blastic lesion

36
Q

Which matrix calcification occurs in fibrous tissue?

A

Ground glass

37
Q

matrix calcification

Where does target calcification occur?

A

Fat

38
Q

matrix calcification

Where does stippled calcification occur?

A

Cartilage

39
Q

matrix calcification

Where does blastic lesion occur?

A

Osseous structures

40
Q

matrix calcification

Where does ground glass occur?

A

Fibrous tissues

41
Q

If there is an aggressive periosteal reaction, will there be a mass extending beyond bone into soft tissue?

A

Yes

42
Q

If you can see displacement of facial planes, will there be a mass extending beyond bone into soft tissue?

A

Yes

Musculoskeletal Physiopathology (15 decks)

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