Bone lesions

Question 1

epiphyseal lucent lesion eccentrically located at the end of long bones

Answer 1

giant cell tumor

Question 2

Multifocal giant cell tumors seen in what conditions?

Answer 2

Paget disease or hyperparathyroidism

Question 3

Treatment for GCT

Answer 3

curettage or wide resection

Question 4

LCH is caused by

Answer 4

abnormal proliferation of histiocytes

Question 5

Classic appearance of LCH in the skull

Answer 5

beveled edge appearance

Question 6

beveled edge appearance

Answer 6

LCH in the skull

Question 7

floating tooth

Answer 7

LCH, 2/2 resorption of alveolar bone

Question 8

Ewing sarcoma cell type

Answer 8

small round cell tumor

Question 9

ewing sarcoma demonstrates male or female dominance?

Answer 9

male

Question 10

Second most common pediatric primary bone tumor

Answer 10

ewing sarcoma

Question 11

radiographic features of ewing sarcoma

Answer 11

aggressive lytic lesion in a child with permeative bone destruction, aggressive periosteal reaction, and soft tissue mass

Question 12

most common primary bone tumor in patients over 40

Answer 12

multiple myeloma

Question 13

what is sclerosing myelomatosis associated with?

Answer 13

POEMS syndrome: Polyneuropathy, organomegaly (liver/spleen), endocrine disturbances (amenorrhea/gynecomastia), monoclonal gammopathy, skin changes

Question 14

Ivory vertebral body

Answer 14

lymphoma

Question 15

most common soft tissue tumo

Answer 15

lipoma

Question 16

circumscribed lucent lesion in the calcaneus with thin rim of peripheral sclerosis

Answer 16

intraosseous lipoma

Question 17

most common sites for intra osseous lipoma

Answer 17

calcaneus, subtrochanteric region of the femur, distal tibia/fibula, and metatarsals

Question 18

features suggesting well differentiated liposarcoma

Answer 18

large size (>10cm), thick septations, globular nodular soft tissue, or composition consisting of <75% fat

Question 19

hollow fluid filled lesion typically found in the proximal diaphysis of the humerus or femur

Answer 19

simple bone cyst/unicameral bone cyst

Question 20

location of simple bone cyst

Answer 20

central. typically at proximal diaphysis.

Question 21

nonsurgical treatment option for simple bone cyst

Answer 21

intra-lesional injection of methylprednisolone –> induces osteogenesis

Question 22

fallen fragment sign

Answer 22

simple bone cyst

Question 23

What is typically more expansive, ABC or simple bone cyst?

Answer 23

ABC is more expansile. Typically SBC won’t be wider than the physis

Question 24

Histologically what are ABCs made of?

Answer 24

blood filled sinusoids and solid fibrous elements

Question 25

osseous mets are \_\_\_\_x more common than primary bone tumors

Answer 25

10x more common

Question 26

Lytic mets

Answer 26

lung, breast, thyroid, kidney, stomach, colon

Question 27

Blast mets

Answer 27

breast, prostate, seminoma, TCC, mucinous tumors, carcinoid

Question 28

what is myositis ossificans?

Answer 28

heterotopic bone formation in the skeletal muscle secondary to trauma

Question 29

most common sites for myositis ossificans?

Answer 29

elbow, thigh (more prone to trauma)

Question 30

Evolution of myositis ossificans (time line)

Answer 30

weeks 1-2: soft tissue mass weeks 3-4: formation of osteoid matrix (may cause periosteal rxn to adjacent bone) weeks 5-8: periphery of lesion matures into compact bone up to 6 months: ossification continues to mature \>6 mo: typically decreases in size

Question 31

benign lytic lesion seen in patients with hyperparathyroidism

Answer 31

brown tumor in HPT

Question 32

Answer 32

subperiosteal abscess. happens in peds, Periosteum is loose in pediatrics and bone infection decompresses in the subperiosteal space

Question 33

Answer 33

[brodie abscess](https://radiopaedia.org/articles/brodie-abscess-1) subacute osteomyelitis T1 bright rim = PENUMBRA sign

Question 34

Answer 34

[brodie abscess](https://radiopaedia.org/articles/brodie-abscess-1)

Question 35

Answer 35

Question 36

Answer 36

Periosteal chondroma The radiograph and MR images depict a periosteal chondroma (synonym: juxtacortical chondroma), which is a benign, cartilage tumor arising on the surface of the bone deep to the periosteum. They have a predilection for the metaphysis of long bones. Radiographically, the lesion causes saucerization of the cortex with sclerotic margination and dense periosteal reaction along the proximal and distal ends of the lesion. Lesion matrix mineralization is present in approximately 75% of cases. The lesions are hypointense on T1-weighted and hyperintense on T2-weighted MR images, owing to the chondroid composition. The lesions are rare, accounting for \<2% of all chondromas.

Question 37

Ollier disease is associated with what malignant transformation

Answer 37

Chondrosarcoma

Question 38

definition of a giant enostosis

Answer 38

\> 2cm

Question 39

osteopoikilosis inheritance pattern

Answer 39

AD

Question 40

Do osteomas originate from the medullary cavity or cortex?

Answer 40

osteomas arise from the cortex associated with Gardner syndrome

Question 41

distribution of melorheostosis

Answer 41

usually lower limb in the distribution of a single sclerotome

Question 42

treatment of osteoid osteoma

Answer 42

RFA, surgical curettage or resection

Question 43

where do sarcomas metastasize?

Answer 43

the lungs

Question 44

does Ollier or Maffucci syndrome have a higher risk of malignant transformation to chondrosarcoma?

Answer 44

Maffucci syndrome

Question 45

cartilage cap thickness \> ________ on MRI suggests malignant transformation of an osteochondroma

Answer 45

\>1.5cm

Question 46

unique signal characteristic of chondroblastoma on MRI

Answer 46

T2 dark

Question 47

most common adult soft tissue sarcoma

Answer 47

MFH