Disorders of the Musculoskeletal System

Question 1

MC benign bone tumor of the vertebra

Answer 1

hemangioma

Question 2

MC benign bone tumor of the body (sessile [no stalk] and pedunculated

Answer 2

osteochondroma

Question 3

reduced bone mineral density, age, postmenopausal, nutrient deficiency, vertebral body compression fractures, fracture of femoral neck, much worse in women

Answer 3

osteoporosis

Question 4

osteolysis followed by deposition of disorganized bone, enlarged bone that lacks strength (shaggy appearance), axial skeleton, femur, skull, pelvis, ivory vertebra, nerve compression, fractures

Answer 4

Paget disease

Question 5

children, bowing of femur and tibia Vit D deficiency

Answer 5

Rickets

Question 6

Vitamin D deficiency

adults, more mild, similar to Rickets

Answer 6

osteomalacia

Question 7

disruption of vascular supply to bone (fracture), bony necrosis, hip, shoulder

Answer 7

avascular necrosis

Question 8

arrested development of bone, bone softening, most severe when involving multiple bones (polyostotic), femur (Shepard’s crook), craniofacial distortion, severe distortion

Answer 8

fibrous dysplasia

Question 9

Polyostotic fibrous dysplasia, café-au-lait spots, precocious puberty (endocrinopathy)

Answer 9

McCune-Albright syndrome

Question 10

malignant, adolescence, Caucasians, femur, pelvis, periosteal reaction (onion skinning)

Answer 10

Ewing sarcoma

Question 11

bone marrow infection, S. aureus, M. tuberculosis, involucrum

Answer 11

Osteomyelitis

Question 12

pronounced ankylosis on the anterior segment of vertebral bodies, common on anterior cervical vertebrae, “flowing ossification” or “melted candle wax,” idiopathic, diabetes

Answer 12

Diffuse idiopathic skeletal hyperostosis (DISH): (AKA Forestier’s disease)

Question 13

benign bone forming tumor, round lesion, smaller than 2 cm in diameter, subcortical, central nidus (radiolucent), pain, nocturnal pain that is relieved by aspirin

Answer 13

Osteoid osteoma

Question 14

malignant bone forming tumor, aggressive, adolescents, most common bone forming tumor, periosteal reaction (Codman triangle, sunburst), metaphyseal region of long bones, very common around knee (distal Femur or proximal tibia), amputation

Answer 14

Osteosarcoma

Question 15

benign cartilage forming tumor, large cartilage-capped outgrowth, metaphysis, males, age 10-30, slow growing, cortex merges, common around knee

Answer 15

osteochondroma

Question 16

several osteochondromas

Answer 16

Multiple hereditary exostosis

Question 17

benign cartilage forming tumor, circular lucency with a narrow ring of sclerosis, almost always in hands

Answer 17

Enchondroma

Question 18

multiple enchondromas of the hand

Answer 18

Ollier disease

Question 19

malignant cartilage forming tumor, periosteal reaction (thinning or thickening), males, adulthood, pelvis, shoulders, develop inside medullary cavity and may expand into surrounding soft tissue (palpable mass)

Answer 19

Chondrosarcoma

Question 20

Congenital disorder of bone: Fibroblast growth factor receptor (FGFR) gene mutation, shortening of long bones, frontal bossing, midface hypoplasia, bullet vertebrae, central spinal canal stenosis

Answer 20

Achondroplasia

Question 21

Congenital disorder of bone: abnormal type I collagen, affects all extracellular matrix: weak bones, skin, joints, irregular teeth, hearing loss

Answer 21

Osteogenesis imperfecta (brittle bone disease)

Question 22

Congenital disorder of bone: stone bone, dysfunctional osteoclasts, marrow fills, fractures, cranial nerve palsies, Erlenmeyer flask deformities

Answer 22

Osteopetrosis

Question 23

degenerative joint disease, most common joint disorder, altered articular cartilage, age-related, trauma or infection may accelerate, associated with subchondral cysts, Heberden nodes

Answer 23

Osteoarthritis

Question 24

abnormal purine metabolism, uric acid crystals in synovium (tophi), males, adulthood, most common in hallux (podagra), cyclical clinical appearance

Answer 24

Gout

Question 25

calcific tendinitis, hydroxyapatite deposition into tendons, idiopathic, most commonly involves the rotator cuff muscles (supraspinatus), 40-70 years of age, reduced range of motion, pain, swelling

Answer 25

Hydroxyapatite deposition disease (HADD)

Question 26

phosphate deposition into cartilage, knee, wrist, faint calcific appearance in the joint space, elderly; contrast with images of HADD

Answer 26

Calcium pyrophosphate deposition disease (CPPD) (AKA pseudogout)

Question 27

Borrelia burgdorferi from Ixodes deer tick, early Bullseye rash (erythema chronicum migrans)

Answer 27

Lyme arthritis

Question 28

aggressive skeletal muscle cancer, children, head, neck, rhabdomyoblasts

Answer 28

Rhabdomyosarcoma

Question 29

malignant smooth muscle tumor, uterus (females), cigar-shaped nuclei

Answer 29

Leiomyosarcoma

Question 30

benign smooth muscle tumor, uterine “fibroids,” small intestine

Answer 30

Leiomyoma