14.1 Bone Pathology Flashcards Preview

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Flashcards in 14.1 Bone Pathology Deck (92):
1

What are features of benign bone neoplasias?

  • asymptomatic
  • symmetrical
  • displaces teeth
  • expands cortex
  • corticated rim on radiograph

2

What are features of malignant bone neoplasias?

  • symptomatic
  • asymmetrical
  • extends past cortex
  • ill-defined borders
  • destroys adjacent structures, including teeth

3

osteogenesis imperfecta is a defect in what?

Collagen Type I maturation

4

What is the most common inherited bone disease?

osteogenesis imperfecta

5

How does osteogenesis imperfecta present clinically?

  • blue sclera
  • altered teeth (brown to blue)
  • long bone/spine deformities
  • hearing loss

6

What is this feature called?

Wormian bones of the skull (mosaic pattern)

7

What disease is this feature associated with?

Osteogenesis Imperfecta

8

What type of Osteogenesis imperfecta is the mildest and most common, and which is the most severe?

Type I is mildest

Type III is most severe

9

What is also known as the "marble bone disease"?

osteopetrosis

10

What is adult-type osteopetrosis also called?

Benign osteopetrosis

11

What is unique about this patient's radiograph?

Bone is more radiopaque than normal. Probably has osteopetrosis.

12

What are these lesions caused by?

Osteopetrosis caused his bone to necrose, leading to these fistulous tracts.

13

Why are this child's eyes blue?

osteogenesis imperfecta

14

Pt sits down in chair and presents with these teeth. Eyes are blue and legs are bowed. What are you thinking they might have?

osteogenesis imperfecta

15

What are characteristics of infantile osteopetrosis?

  • poor prognosis
  • marrow failure
  • facial deformities
  • frequent fractures

16

This is clearly not natural. What could they have if their teeth are also involved?

cleidocranial dysplasia

17

This pano looks good right? No. What does this patient have?

cleidocranial dysplasia

18

What are some features of Cleidocranial dysplasia?

  • prolonged retention of primary teeth
  • supernumary teeth
  • clavicular hypoplasia
  • high-arched palate

19

What is an increased radiolucency of the bone marrow called?

Focal Osteoporotic Marrow Defect

20

Features of Focal Osteoporotic Marrow Defect?

  • no jaw expansion
  • ill-defined borders
  • fine central trabeculations
  • typically asymptomatic

21

Define Idiopathic Osteosclerosis.

A focal area of increased radiodensity that is of unknown cause but cannot be attributed to anything else

22

What is this? (hint: no hx of infection)

Idiopathic osteosclerosis

23

What is this?

idiopathic osteosclerosis

24

What are radiographic features of idiopathic osteosclerosis?

  • well-defined borders
  • usually associated w/ root apex
  • more radiopaque than surrounding bone

25

How should you treat idiopathic osteosclerosis?

No treatment is necessary unless there are symptoms or the bone pathology keeps growing

26

Pt has a clinically obvious Mn deformity and reports pain. You report extreme tooth mobility in Q3. What could this be?

massive osteolysis

27

This pathology presents more in children and young adults, and is seen more in the Mn than the Mx. It typically results with the total loss of the bone affected. What is this?

massive osteolysis

(pt has obvious deformity, pain, tooth mobility, and deviation of the mandible)

28

What bone pathology is abnormal deposition and resorption of bone, commonly polyostotic, and forms near joints?

paget's disease of bone

29

What sign is noted when pt has paget's disease of the skull?

Increasing circumference of the skull

30

What is leontiasis ossea?

A "lion-like" facial deformity where the middle 1/3 of the face is enlarged (seen in Paget's disease)

31

What is the appearance of bone upon radiograph in Paget's disease of bone?

cotton wool or cotton roll

32

The cotton roll appearance of bone here may suggest what pathology?

Paget's disease of bone

33

How would you describe this pt's mandible? What polyostotic disease is this?

  1. cotton wool appearance
  2. paget's disease of bone

34

What bone pathology frequently occurs in the anterior mandible and crosses the midline?

Central Giant Cell Granuloma

35

What two other pathologies should be tested for if you think it's central giant cell granuloma?

brown tumor of hyperthyroidism and cherubism

36

This pathology is not considered a neoplastic condition, and frequently involves the anterior Mn. What is this?

Central giant cell granuloma

37

This will histologically appear like brown tumor of hyperthyroidism. What is this?

central giant cell granuloma

38

What is this developmental jaw condition that usually goes away by 30 years old?

cherubism

39

What are two physical features of people with cherubism?

1. plump cheeks

2. upturned eyes

40

What is the disease course of cherubism?

  1. Dx usually between 2-5
  2. Disease progresses through puberty
  3. Disease usually resides by 30

41

What is this?

Cherubism

42

What is a traumatic bone cyst?

A benign, empty, or fluid filled cavity within the bone.

43

Why is the name traumatic bone cyst a misnomer?

Because the cavity is NOT lined by epithelium like a true cyst.

44

What is this cavity called? (hint: not lined by epithelium)

Traumatic bone cyst 

45

You get into this bone during surgery and find no epithelial lining. What is your likely diagnosis?

Simple bone cyst

(aka traumatic bone cyst)

46

What a unique radiographic feature seen in simple bone cysts?

"scalloped" border along the tooth roots

47

What age range is most popular to see Traumatic bone cysts?

10-20 yrs

48

You see a radiolucent area on the radiograph and upon surgery find this. What is this? (hint: hole was there and no lining was seen in hole)

Traumatic bone cyst

49

Define Aneurysmal Bone Cyst.

An intraosseus accumulation of blood-filled spaces surrounded by connective tissue.

50

Why is an Aneurysmal bone cyst not a true cyst?

It doesn't have an epithelial lining

51

Unilateral x-ray finding on 20 year old patient. They report pain and that it developed quickly. What could this be?

Aneurysmal bone cyst

52

What age is most common to see an aneurysmal bone cyst?

20 yrs old

53

What is the most common clinical sign of an aneurysmal bone cyst?

Rapid swelling of the mandible

54

Image shows intraosseus bone surrounded by connective tissue. What is this?

Aneurysmal bone cyst

55

What is the clinical appearance of an Aneurysmal bone cyst?

A "blood-soaked" sponge

56

What are three examples of fibro-osseous lesions?

  1. fibrous dysplasia
  2. cemento-osseous dysplasia (types: focal, periapical, florid)
  3. ossifying fibroma

57

What kind of benign fibro-osseous lesion is characterized by the replacement of normal bone by fibrous CT with altered bone?

Fibrous dysplasia

58

Define polyostotic.

Involving multiple bones

59

What types of fibrous dysplasia are there?

Monostotic and polyostotic.

60

What are two syndromes associated with polyostotic fibrous dysplasia?

  1. Jaffe-Lichtenstein syndrome
  2. McCune-Albright syndrome

61

Polyostotic fibrous dysplasia, coast of maine cafe au lait spots, and multiple endocrinopathies are diagnostic for which syndrome? 

McCune-Albright syndrome

62

What is the radiographic evidence of monostotic fibrous dysplasia?

A "ground-glass" appearance

63

Bone has a ground-glass appearance. What is this?

Monostotic fibrous dysplasia

64

Radiograph suggests fibrous dysplasia and pt has coast of maine cafe au lait spots. What syndrome might they have?

Jaffe-Lictenstein syndrome

65

If your pt presents with polyostotic fibrous dysplasia, cafe au lait spots (coast of maine), and reports very early puberty - what syndrome might they have?

McCune-Albright syndrome

66

What is the most common fibro-osseous lesion encountered in clinical practice?

Cemento-osseous dysplasia

67

Focal cemento-osseous dysplasia occurs most commonly in what demographic?

African-american (and 90% are females)

68

What differentiates focal cemento-osseous dysplasia from Idiopathic osteosclerosis and condensing osteitis?

A thin radiolucent rim around the lesion.

69

Pt is a 40 yr old black female. What can the radiograph be showing?

Focal cemento-osseous dysplasia

70

What is the physical difference between focal, periapical, and florid cemento-osseous dysplasia?

Focal is local to one tooth

Periapical is root(s)

Florid is generalized

71

Based on the RO core and RL border of this lesion, what kind of cemento-osseous dysplasia is this?

Periapical

72

What area of the mouth is involved with periapical cemento-osseous dysplasia?

Anterior mandible

73

What could this florid condition be?

Florid cemento-osseous dysplasia

74

Biopsy of florid COD can cause what to happen to the bone?

Can become necrotic from hypovascularity

75

Root divergence or resorption can occur with what kind of benign fibro-osseous lesion?

ossifying fibroma

76

What unique physical feature shows with large ossifying fibromas?

A downward bowing of the inferior cortex of the mandible

77

Do ossifying fibromas undergo malignant transformation?

Nopers

78

Ossifying fibroma occurs more in the Mx or Mn? And in females or males?

Mn > Mx

F > M

79

Does juvenile ossifying fibroma occur more in the Mn or Mx? And in females or males?

Mn < Mx

F < M

80

What are the two variants of juvenile ossifying fibroma?

Trabecular and Psammomatoid

81

Is this psammomatoid or trabecular juvenile ossifying fibroma?

Psammomatoid

82

What is a benign tumor of mature bone called?

Osteoma

83

What location of osteoma is most common?

paranasal sinus

84

Multiple osteomas might be a sign the patient has ________ _________. 

Gardner syndrome

85

Gardner Syndrome is characterized by what manifestations?

  • colonic polyps/adenocarcinoma
  • skeletal abnormalities
  • pigmented ocular fundus
  • supernumerary teeth

86

T or F: Colonic polyps in Gardner Syndrome WILL transform into adenocarcinoma.

True

87

What is the most common skeletal abnormality of Gardner Syndrome?

osteomas

88

Both osteoblastomas and osteoid osteomas produce prostaglandins, but which one is relieved by aspirin?

Osteoid osteomas (because they're smaller than 2cm and produce less prostaglandins)

89

What is an odontogenic neoplasm of cementoblasts that's almost always seen in the molar/premolar region?

Cementoblastoma

90

Is the PDL dinstinctly visible in cementoblastomas?

No, and the cementoblastoma is surrounded by a thin RL rim

91

What is this?

cementoblastoma

92