Week 4: Spine Pathologies and Bone Tumours

Question 1

Transitional Vertebra

Answer 1

Occurs at transition from one spine type to another
◦ C to T spine, T to L spine, L spine to sacrum Vertebra contains elements from both types
◦ C7 may have a rudimentary rib, called a cervical rib
◦ L1 may have rudimentary ribs
◦ Last L spine (usually L5) has larger transverse processes
which join with sacrum

Question 2

Ankylosing Spondylitis

Answer 2

Chronic inflammation in joints and ligaments, affecting the spine that, over time, causes some of the vertebrae in spine to fuse causing spine to become stiff and rigid
May be called spondyloarthritis
This fusing makes the spine less flexible and can result
in a hunched-forward posture
If ribs are affected, it can be difficult to breathe deeply
*Ossification in tissues and ligaments of the spine as
well as lateral bony bridges between vertebral bodies
limit patient movement
*Leads to generalized osteoporosis
*Bones fracture easily

Question 3

Intervertebral Disk Herniation

Answer 3

Weakened or torn annulus fibrosus ruptures allowing nucleus
pulposus to protrude and compress spinal nerve roots

Question 4

Spina Bifida

Answer 4

Birth (congenital) defect that occurs when the spine and spinal cord don’t
form properly at posterior side
a, a portion of the
neural tube fails to develop or close properly, causing defects in the
spinal cord and in the bones of the spin

Question 5

Spina Bifida Occulta

Answer 5

mildest form, “hidden”, splitting of bony neural canal at L5 or
S1 so small gap in spine, asymptomatic

Question 6

Spina Bifida Meningocele

Answer 6

SF from around brain and spinal cord leaks through
spinal gap and forms sac on back, likely asymptomatic

Question 7

Spina Bifida Myelomeningocele

Answer 7

most severe, portion of spinal cord and nerves protrude out of spine into sac on back, may cause muscular
abnormalities, limited movement, bladder and bowel control
impairment

Question 8

Spondylosis

Answer 8

Also known as spinal
osteoarthritis or degenerative
OA, a degenerative disorder
with narrowing of disc spaces,
that may cause loss of normal
spinal structure and function
*Age related
*Spondylosis causes growth of
bone spurs (osteophytes) or
bony bridges around a
degenerating intervertebral
disc in the spine

Question 9

Spondylolysis

Answer 9

A defect (fracture/stress
fracture) in the pars
interarticularis WITHOUT
displacement

Question 9

Spondylolisthesis

Answer 9

Defect (fracture) in the pars interarticularis of a vertebra WITH displacement;“listhesis” means “to slip forward”

Question 10

Osteochondroma

Answer 10

(exostosis) is a benign
projection of bone with a cartilaginous cap that arises in childhood or teen
years, especially in the knee

Question 11

Simple Bone Cyst – Unicameral Cyst

Answer 11

A true fluid-filled cyst with a wall of fibrous tissue
Expansile lucent lesion with a thin rim of sclerosis
* Oval configuration, with its long axis parallel to
that of the host bone
* May cause cortical bone thinning
* May look like malignancy on x-ray imaging

Question 12

Aneurysmal Bone Cyst

Answer 12

More common in peds than adults
* Numerous blood-filled cysts, with atriovenous
communications
* Can expand beyond bone
* Can cause pain, swelling, pathological fracture
* Can be highly destructive
* Imaging appearance:
* Lesions may show internal separation
* May cause cortical thinning and ballooning

Question 13

Osteosarcoma
(Osteogenic Sarcoma)

Answer 13

a malignant bone tumor
occurring generally in persons 10
to 25 years of age
The most common malignant
primary bone tumor in children
Classic “sunburst” appearance

Question 14

Ewing’s Sarcoma

Answer 14

The second most common malignant
primary bone tumor in children
* Occurs in children and young adults
* Arises in the medullary cavity/bone
marrow
Moth eaten appearance

Question 15

Multiple Myeloma

Answer 15

A disseminated (widespread) malignancy/cancer of plasma
cells that may be associated
with bone destruction, bone
marrow failure, hypercalcemia,
renal failure, and recurrent infections

Question 16

Metastatic Bone Lesion

Answer 16

More common than primary bone cancer Also called secondary bone cancer A metastatic bone lesion/tumor is a malignant secondary bone tumor that was spread via the bloodstream or lymphatic vessels from primary tumors of breasts, lung, prostate, kidney and thyroid to bone
* Typically spread to bones
containing red bone marrow –
spine, pelvis, ribs, skull,
shoulders and hips
* Has many different
appearances on x-ray images