Vicki Radiology Flashcards
15 year old male with increasing left upper arm pain of 3mo duration. Recent onset of low grade fever. Local tenderness and it extends into soft tissue. What tumor? And name the genetics.
t(11,22) causing fusion protein EWS-FLI1 - ewing Sarcoma
p53 damage
osteosarcoma, Li Fraumeni
bone decreased bloody supply
avascular necrosis/osteonecrosis
failure of normal bone resportion due to defective osteoclasts
osteopetrosis
**diaphysis lesions
ewing, myeloma, osteoid osteoma
**metaphysis lesions
osteosarcoma, osteochondroma
**epiphysis lesions
giant cell tumor
decreased cortical thickening
osteoporosis
diffuse, dense bone
osteopetrosis
thickening of calvarium
osteitis deformans (Paget dz of bone)
XR shows irregular lucencies with adjacent sclerosis
osetonecrosis
MRI shows dark serpingious necrotic bone
osetonecrosis
bamboo spine
ankylosing spondylitits
XR shows soap bubble appearance
giant cell tumor
XR shows exotosis of bone
osteochondroma
XR shows “sunburst pattern”/”Codman” Triangle around metaphysis of long bones
osteosarcoma
Best test for soft tissue involvement (malignancy).
MRI
Anaplastic small blue cell tumor
Ewing Sarcoma
XR shows “onion skin” around diaphysis of long bone
ewing sarcoma
What cancers have blue cells?
MR. LEMONS Melanoma Rhabdomyosarcoma Lymphoma Ewing Medulloblastoma Other Neuroblastoma Small Cell (oat cell)
32 year old male with a hx of and current presentation of multiple fractures after tripping. Slight weakness in facial mm and decreased hearing on left. On XR, see bright bone/lucent bone.
Osteopetrosis (CAnhydrase mutation - super dense outside, bone widening)
Spongiosa filling the medullary canal with no mature trabeculae
osteopetrosis
trabecular thinning with fewer connections
osteoporosis
lamellar bone structure resembling mosaic
paget disease
In osteopetrosis, what manifestation causes pancytopenia?
Bone fills marrow space
What artery supplies the head of the femur? Results of insufficiency of this artery.
Medial circumflex femoral artery - insufficiency causes osteonecrosis (avascular necrosis).
Main causes of osteonecrosis
CS (also fx, sickle cell, alcoholism, pancreatitis, Legg-Calve perthes disease)
XR shows crescent sign (dead bone)
MRI shows rim sign (fluid between sclerotic borders)
osteonecrosis
Patients with primary malignant and benign bone tumors present with pain, swelling, and occasionally pathologic fracture of the involved bone. Biopsy shows non-neoplastic osteoclasts and their precursors.
Giant cell tumor (osteoclastoma)
increased ostoid
osteoid osteoma, osteoblastoma, giant cell tumor
what is one of the only bone tumors that occurs at the epiphysis?
giant cell tumor (osteoclastoma) in the femur or tibia
if giant cell tumor (osteoclastoma) mets, where will it go 3% of the time?
lungs
osteoclast dysfunction
Osteitis deformans (Paget disease of bone)
osteoblast dysfunction
osteoporosis
defective mineralization of osteoid
osteomalacia
infarction of bone and marrow
osteonecrosis
> 50 years old. patients experience pain, skeletal deformity, neurological symptoms, pathologic fractures, increased hat size, increased output heart failure, osteosarcoma, bowed tibia and deafness (due to narrowing of auditory foramen).
Osteitis deformans (Paget disease of bone)
XR shows a 14 year old boy with a densly sclerotic lesion in distal femur extending form growth plate into diaphysis. (so the metaphysis). What is this cancer and what is the term for when the periostium lifted, forming angle with the cortex
Codman’s triangle,
osteosarcoma
20yo male with painless, hard subcutaneous mass in popliteal fossa that is cartilage-capped.
osteochondroma
osteochondroma can transform into ___
chondrosarcoma (Malig)
osteochondromas develop in bones of ___ origin in the ____
*endochondral origin in the *metaphysis near growth pate of long tubular bone
Both MCP joint of a 37yo woman were swollen and tender. Early morning stiffness. She is likely to have…
Pannus formation. (this is Rheumatoid arthritis).
DIP and PIP - what arthritis and what nodes?
Osteoarthritis
DIP=Herberden nodes
PIP=bouchard nodes
ossociate with osteophytes and subchondral cysts
Hitchhikers thumb deformity, ulnar deviation and boutonniere and swan neck.
Rheumatoid Arthritis
• Most commonly affects boys
Ewing Sarcoma
▫ Sandwich vertebrae: dense bands of sclerosis parallel to endplates ▫ Bone widening ▫ Erlenmeyer flask deformity of tubular bones • Medullary encroachment
AD adult B9 ostepetrosis
MRI: ▫ Heterogeneous signal intensity with low to intermediate intensity
▫ Focal cystic areas
▫ Low-signal intensity pseudocapsule
Giant cell tumor
Skull deformities
▫ Diploic thickening of inner and outer calvarium
▫ Cotton wool appearance: mixed lytic and sclerotic lesions
▫ Frontal bone enlargement
Paget disease
**Develop only in bones of endochondral origin
and arise from the metaphysis near the growth
plate of long tubular bones.
• This tumor is are slow growing tumors and can present as painful if they impinge on a nerve or if the stalk is fractured.
Osteochondroma
herberden nodes, bouchard nodes, subchndral cysts
osteoarthritis
pannus formation
rheumatoid arthritis
