TUMORS Flashcards
10-25
Most commonly found in diaphysis of long bones
Ewing’s sarcoma
Permeative lesion that causes a multi-paralleled onion skin (laminated) type of periosteal reaction
Bone expansion
Codman’s triangle
Saucerization
Ewing’s sarcoma
M/c malignancy found in children
Osteosarcoma
10-30
Osteosarcoma
Labs osteosarcoma
Increased alkaline phosphatase
Special test osteosarcoma
Bone scan
Chondrosarcoma age
> 40
Fibrosarcoma age
> 40
Encapsulated Short zone of transition Geographic lesion Incidental findings No labs Refer to orthopedist
Benign bone tumors
Benign bone tumorsUsually asymptomatic except
Osteoid osteoma
Skeletal pain worse at night Unexplained weight loss Cachexia Long zone of transition Non-encapsulated Permeative pattern of destruction Refer to oncologist
Malignant bone tumors
Bone pain
Older
Malignant bone tumors
Grows from the center outward
<20
Diaphyseal/metaphyseal location
Concentric/centrally located
Unicameral bone cyst (UBC)
UBC aka
Simple bone cyst (SBC)
Associated with fallen fragment sign
Fluid filled tumor
Always symmetrical
Extends cortex to cortex
Unicameral bone cyst
Simple bone cyst
<20
Diaphyseal/metaphyseal location
Eccentrically located
Expands bone
ABC
ABC
Aneurysmal bone cyst
Blood filled tumor (blood spongy filled)
Associated with blister of bone or finger in balloon appearance
Asymmetrical
Aneurysmal bone cyst (ABC)
Giant cell tumor aka
GCT
Osteoclastoma
Knee
Wrist
Sacrum
GCT
Epiphyseal/metaphyseal location
20-40
Giant cell tumor
20% of the time quasi-malignant
Associated with soap bubble appearance (saponaceous)
GCT
Epiphyseal/metaphyseal location
<20
Open growth plates
Chondroblastoma
Small fibrous tumor that affects the metaphysis of the bone
Don’t expand bone
Under 8 years of age
Under 2 cm
Fibrous cortical defect
Small fibrous tumor that affects the metaphysis of the bone Don’t expand bone Scallop, almost bubbly Over 9 years of age Over 2 cm
Non-ossifying fibroma
Monostotic form associated with rind sign - 70%
Physiologic resorption of normal bone replaced by fibrous tissue
Fibrous dysplasia
Causes deformity saber shin tibia and shepprds crook
Ground glass appearance
Cafe au leit spots with coast of maine appearance
Fibrous dysplasia
Most common BBT of the spine
Hemangioma
Will appear with vertical striations called corduroy cloth or jail bar vertebrae
If more than 2 segments osteoporosis
Hemangioma
Night pain relieved by aspirin
Deep pain
Radiolucent central nidus with severe reactive sclerosis and bone expansion
Small black hole surrounded by a LOT of white
Osteoid osteoma
Nubmer one diff is brodies abscess - adv osteomyelitis
Osteoid osteoma
Cauliflower like pedunculated, coat hanger exostosis, cartilaginous cap
Osteochondroma
Sessile aka broad based exostosis like little mountain
Osteochondroma
Most common BBT of the appendicular skeleton
Osteochondroma
Always point away from joint
Hereditary multiple exostosis (HME) are multipl
Osteochondromas
HME’s can be
Quasi-malignant
Most people don’t know they have them
Osteochondroma
Most common BBT of the hand or foot
Enchondroma
Thinned cortex May have a stippled appearance Matrix calcification Expansile but never breaks it Geographic - isolated to one specific area of spien
Enchondroma
Multiple enchondromas is called
Ollier’s disease
Ollier’s
10-50% rate of malignant degeneration
Mafucci’s
Multiple enchondromas ollier’s disease with swelling and deformity
M/c BBT to affect teh neural arch and cause bone expansion
Osteoblastoma
Affect neural arch and cause bone expansion
Osteoblastoma
ABC
GCT
M/c BBT to affect the skull
Osteoma
M/c found in the frontal sinus and best seen on the caldwell projection
Osteoma
Brodie’s abscess aka
Chronic osteomyelitis
Night pain relieved by aspirin
Brodie’s abscess
Multiple bone islands (enostomas)
Tiny white dots within a bone
Small white densities similar in size and shape
Osteopoikilosis
No labs M/c found in humerus, pelvis, hands and feet Bone-in-bone Hepatosplenomegaly Any age
Osteopoikilosis
Polka dot bones - systemic
Osteopoikilosis
Systemic
Every bone affected
Osteopetrosis aka
Albers schonbergs
Marble bone disease
In extremities - every bone on film ivory white vertebrae
Osteopetrosis
Radiographic sign osteopetrosis
Marble bone
Bone-in-bone
Sandwich vertebrae
Osteopetrosis
Bone infarct aka
Osteonecrosis
Caisson’s disease
AVN to the metaphysis of bone in medulla
M/c distal tibia or prox humerus
Bone infarct
Seen in deep sea divers and flight attendants
Diabetics
Pilots
Bone infarct
Radiographic signs bone infarct
Sepemginous calcification (snake-like)
Most common joint affected is knee
White popcorn like appearance in and around synovial joints
Bakers cyst calcified could be too
Synoviochondrometaplasia
Synovio-osteochondromatosis
Chondrodystrophic calcification
Major cause synoviochondrometaplasia
Trauma and adv DJD
Will never extend past joint capsule
Will not hit every bone
