Bone lesions: Flashcards Preview

MSK > Bone lesions: > Flashcards

Flashcards in Bone lesions: Deck (57):
1

Mnemonic to remember B9 lytic bone lesions:

FEGNOMASHIC

2

FEGNOMASHIC stands for:

Fibrous dysplasia
Enchondroma (and Eosinophilic granuloma)
Giant cell tumour
Non ossifying fibroma
Osteoblastoma
Mets and Myeloma
Aneurysmal bone cyst
Solitary bone cyst
HyperPTH
Infection
Chondroblastoma (and Chondromyxoid)

3

What are the characteristics for fibrous dysplasia (FD): (3)

1. No periosteal reaction- not painful
2. Never undergoes malignant degeneration
3. Ground glass (BUZZWORD) lytic lesion with hazy matrix

4

Diagnosis?
This lesion is seen in the tibia and the jaw and it resembles FD with malignant potential

Adamantinoma
Rx and Hx (histologically) resembles FD

5

Diagnosis?
Polyostotic FD with cafe au lait spots and precocious puberty

Mc Cune Albright syndrome

6

Define Cherubism

This is the presence of multiple lesions of FD in the jaw that has been termed Cherubim.
Puffed out cheek having an angelic look- the jaw lesions regress in adulthood

7

Typical features for enchondroma: (2)

1. cytic/lytic lesion with Ca++ except in phalanges
2. No periostitis - Painless

8

Difference bwn enchondroma in phalanx and elsewhere

phalanx: no calcification

9

Difference bwn enchondroma and bone infarcts: (2)

1. Enchondroma: Endosteal scalloping whereas no scalloping in the other one

2. Sclerotic border in bone infarct

10

Ollier disease

Multiple enchondroma

11

Maffucci syndrome

Multiple enchondroma and soft tissue haemangioma

12

Ddx for bone sequestra

1. EG
2. Osteomyelitis
3. Lymphoma
4. Fibrosarcoma

13

What are the 4 typical characteristics of giant cell tumours?

1. Only in patients with closed epiphyses
2. The lesion must be epiphyseal and abut the articular surface- not in flat bones.
3. Eccentrically located
4. Must have a sharply defined zone of transition (border) that is not sclerotic. not in flat bones.

14

What are the characteristics for NOF: (2)

1. < 30 years old
2. No periostitis or pain

15

What is NOF associated with?

NF - 5%

16

Difference bwn NOF and fibrous cortical defeft

Radiologically and Hx similar- NOF > 2cm and cortical defect < 2cm

17

Diagnosis?
multiple usually unilateral NOFs with cafe au lait spots

Jaffe companacci syndrome

18

Diagnosis?
Same Hx as NOF, but occurs during the 3rd to 5th decade. Looks like GCT on Xray but with well defined sclerotic margin. 1/3 in knee

Benign fibrous histiocytoma

19

DDx for expansile lytic lesion of the posterior elements of the spine (3)m

1. Osteoblastoma
2. ABC
3 TB

20

DDx for lytic expansile met disease (2)

Thyroid and renal tumour.

21

Mini brain sign

plasmocytoma

22

Two different types of ABC

1. Primary: no known cause
2. Secondary to trauma or other lesions (GCT or Osteosarcoma)

23

Discrominators for ABC

1. Must be expansile
2. Younger than 30

24

Where is the most common location for Solitary bone cysts?

2/3 to 3/4 in proximal humerous and proximal femur
They have to be CENTRAL

25

Fallen fragment sign is seen in....

Solitary bone cyst

26

Discriminators for solitary bone cyst (3)

1. MUST be central
2. <30 years of age
3. No periostitis

27

What are the radiological signs of hyper PTH?

1. Subperiosteal bone resorption
2. If physes are open , frayed, ragged appearance

28

Pathognomonic feature of hyperPTH?

Subperiosteal bone resorption

29

Where is subperisosteal resorption in hyperPTH seen? (4)

1. Radial aspect of middle phalanx
2. Distal clavicles
3. Medial aspect of tibia
4. SI joints

30

HyperPTH with osteoporosis and osteosclerosis?

Renal dystrophy secondary to hyperPTH

31

What is the significance of sequestrum in osteomyelitis?

if present, surgical debridement should be considered. Abx alone is not useful.

32

Ddx of a lytic lesion in epiphyses of a patient less than 30 years of age: (3)

1. Infection
2. Chondroblastoma
3. Giant cell tumour

33

Discriminators of Chondromyxoid fibroma (2)

1. Mention when NOF is mentioned
2. No calcified matrix

can present with pain. NOF painless

34

Lesions in patients younger than 30 years of age:

EG
ABC
NOF
Chondroblastoma
Solitary bone cyst

35

Lesions that have no pain or periostitis

Fibrous dysplasia
Enchondroma
NOF
Solitary bone cyst

36

Epiphyseal bone lesion

Infection
GCT
Chondroblastoma
Geode

37

Multiple lytic lesions

FEEMHI:
FD
EG
Enchondroma
Mets and myeloma
HPT/ brown tumour
Infection

38

Benign cystic rib lesions

FAME:
FD
ABC
Mets and myeloma
Enchondroma and EG

39

Sclerotic focus in a 20-40 years old patient as incidental findings

NOF
EG
ABC
Solitary bone cyst
Chondroblastoma

40

malignant epiphyseal tumour....

Clear cell chondrosarcoma

41

FD and soft tissue myxoma in a middle aged woman

Mazabraud

42

Classic features of EG

1. vertebral plana in a kid ie complete collapse of vertebral body
2. skull with lucent "beveled edge" lesion
3. Floating tooth with lytic lesion in alveolar ridge

43

Classic Ddx for vertebral plana

MELT:
Mets/myeloma
EG
Lymphoma
TB/Trauma

44

Multiple myeloma causes vertebral body destruction with sparing of ........ elements.

Bone scan is often ........

posterior


Negative - skeletal survey is better. MRI is most sensitive

45

How would MM manifest as ?

Diffuse osteopenia

46

up to 40% of ABC are associated with....

GCT

47

This bone lesion is often not T2 bright

Chondroblastoma

48

Name the 3 classic lesions in the calcaneus

1. Solitary bone cyst
2. Pseudocyst
3. Interosseous lipoma

49

This lesion is most likely in the inter-trochanteric region of the femur. lytic lesion with sclerotic border. 10% undergo malignant degeneration

Liposclerosing Myxofibroma

50

Only benign tumour associated with radiation

Osteochondroma

- point away from the joint
- BM flows freely into the lesion

51

This is osteochondroma causing joint deformity , most common in ankles and knees

Trevor disease/ dysplasia Epiphyseal Hemimelica- DEH

52

Osseous process that does nothing but can compress the median nerve if the ligament of Struthers smashes it

Supracondylar spur/ Avian spur.

53

In avian spur the median nerve is compressed if the ligament of....... smashes it

Struthers

54

This vs that:
Osteochondroma vs avian spur

In osteochondroma : Points away from the joint
Avian spur: points towards the joint

55

lesion in the finger of a kid with saucerisation of the adjacent cortex with sclerotic periosteal reaction

Periosteal chondroma

56

When i say looks like NOF in ANTERIOR tibia with anterior bowing , you say.....

Osteofibrous dysplasia

57

Destructive mass in a bone of leukaemia patient

Chloroma (Granulocytic Sarcoma)