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Bone Path II > Bone Path II Quiz 2 > Flashcards

Bone Path II Quiz 2 Flashcards

1
Q

What is the most common benign tumor of BONE?

A

Osteochondroma

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2
Q

Who does Osteochondromas affect?

A

<20= 75%

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3
Q

What do Osteochondromas look like on film?

A

Single Lesion
Sessile or Pedunculated
Bony exostosis: cortex continuous projecting away from joint.
Cartilagenous cap

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4
Q

Where are most Osteochondromas?

A

85% in Femur, Humerus, Tibia
Metaphysis of long bone
Any bone with cartilagenous cap.

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5
Q

Can Osteochondromas turn malignant?

A

Yes in >30.

Look for Pain, Osseous destruction, ST mass, Thickening of cartilaginous cap

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6
Q

Multiple Osteochondromas are called…

A

Hereditary Multiple Exocytosis

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7
Q

How many lesionsa re seen in Hereditary Multiple Exocytosis?

A

Ave 10, but hundreds possible

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8
Q

What age group does Hereditary Multiple Exocytosis affect?

A

Dx at 2-10

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9
Q

Can Hereditary Multiple Exocytosis become malignant?

A

Yes in 20% cases

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10
Q

What are the signs/symptoms of Hereditary Multiple Exocytosis

A

Painless, lumpy joints

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11
Q

30% of time, Hereditary Multiple Exocytosis results in _ of the wrist

A

Beyonet wrist deformity (Madenlung’s)

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12
Q

What is the most common benign tumor of SPINE

A

Hemangioma

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13
Q

What age group does Hemangiomas affect?

A

Most >40

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14
Q

What do Hemangiomas look like on x-ray

A

Single lesion (lytic)
Normal Cortex
Rare body expansion
Coarse vertical striation “corduroy cloth” appearance

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15
Q

Where do you most commonly find Hemangiomas?

A

75% in Spine & Skull

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16
Q

What are the symptoms of Hemangiomas?

A

Most ASYMPTOMATIC, but can cause neurologic compromise due to location in spine and skull.

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17
Q

Where do you find Osteomas and what do they look like?

A

Osteomas are round/oval well defined sclerotic lesions found in membranous bones (frontal & ethmoid bone)

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18
Q

Are osteomas painful?

A

No, most asymptomatic

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19
Q

What is the Triad of _ called

  • Multiple osteomas
  • Chronic polyps
  • Soft tissue fibromas
A

Gardner’s Syndrome

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20
Q

Is Gardners Syndrome a genetic disorder?

A

Yes, Autosomal dominalt

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21
Q

What is the big dea about polyps found in Gardners Syndrome?

A

They are considered premalignant.

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22
Q

Where can you find Bone Islands?

A

Any bone except skull. Rare in vertebrae.

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23
Q

Describe Bone Islands

A 
Sclerotic
Sharp margins
Solitary Lesion
Round
Homogeneously dence
Radiating Specules (diagnostic)
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24
Q

What is another name for a Bone Island?

A

Enostoma

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25
What age population do Osteoid Osteomas affect?
10-25 y.o
26
What are the Classic Symptoms of Osteoid Osteomas?
Increasingly severe, deep, aching pain. Not relieved by rest, worse at night. Relieved by asprin.
27
Can osteoid Osteomas referr pain?
Yes, 30% refer to nearby joint.
28
Do you see swelling, tenderness, or stiffness in osteoid osteomas?
Yes.
29
Where to most Osteoid Osteomas occur?
Any bone Cortical most common 50% in femur and tibia
30
What are the plain film findings of Osteoid Osteomas?
Cortical Lesion (80%) Reactive Sclerosis Lucent round nidus Intramedullary and intracapsilar much less sclerotic
31
What do you DDX with Osteoid Osteomas?
Stress Fracture Brodies Abscess Bone Island (normal to bone scan) Osteoblastoma
32
Histologically, what are Osteoblastomas similar to?
Osteoid Osteomas
33
What age group does Osteoblastomas affect?
70% are <20
34
What are the common locations for Osteoblastomas?
Neural Arch of Spine Long bone Meta/Diaphysis Hands, Feet, Skull, Face
35
How do Osteoblastomas and Osteoid Osteomas compare in symptoms?
Less Painful Not nocturnal Not Relieved by Asprin
36
50% of Osteoblastomas in the spine result in what?
Painful Scoliosis
37
How does Osteoblastomas affec surrounding tissue?
Spasms Rigidity Referred pain Spinal Steonosis
38
What to Osteoblastomas look like in the Spine?
Espansile Thin cortical periphery Most Lytic
39
What do Osteoblastomas look like in the Extremities?
Lytic, expansile Epiphysis spared Cortex thin, may disrupt
40
What is the 2nd most common benign tumor of bone?
Enchondroma
41
What age groups do Enchondromas usually affect?
10-30
42
Are pathologic fractures common with enchondromas?
Yes
43
Where do you most commonly find Enchondromas?
50% phalanges | 50% femur, tibia humerus, ribs.
44
What is noteworthy about Enchondromas near the axial skeleton?
They are more ofyten symptomatic and higher likelihood of becoming malignant
45
What do Enchondromas look like on film?
``` Geographic Lytic Expansile Thinned Cortex Metaphyseal-Diaphyseal Calcification in 50% No ST mass ```
46
What is another name for Multiple Enchondromastosis?
Olliers Disease
47
Are Multiple Enchondromasosis bilateral?
No, they are unilateral
48
Can Multiple Enchondromatosis Cause growth changes?
Yes, often result in shortened limb
49
What is the Malignant Transformation rate of Multiple Enchondromatosis?
25-50%-> | Osteosarcoma, Chondrosarcoma, Fibrosarcoma
50
Multiple Enchondromatosis with Soft Tissue Hemangiomas/Phleboliths is called _
Maffucci's Syndrome
51
Chondroblastomas are AKA
Codman's Tumor
52
What age group does Chondroblastomas usually affect?
5-25
53
What is the local recurrance rate of Chondroblastomas?
20%
54
Where do you most often find Chondroblastomas?
2/3 lower extermity (50% knee) | Epiphyseal, but may extend into metaphysis.
55
What do Chondroblastomas look like on plain film?
``` Lytic Geographic Epiphyseal Sharp Zone of Transition Calcification in 50% ```
56
What do you DDX with Chondroblastomas?
Giant Cell | Clear Cell Chondrosarcomas
57
What age group does Chondromyxoid Fibroma affect?
10-30 yo
58
What are the sx of Chondromyxoid Fibromas?
Local Pain & Swelling.
59
What is the most common location for Chondromyxoid Fibromas?
50% in tibia
60
What are the film findings for Chondromyxoid Fibromas?
Eccentric Lytic Soap Bubbly
61
Fibrous Xanthomas comprise what two bone tumors?
Nonossifying Fibroma | Fibrous Cortical Defect
62
What are the difference between Nonossifying Fibroma and Fibrous Cortical Defect?
Nonossifying Fibroma - 8-20 yo - >2cm - Extends to medullary cavity Fibrous Cortical Defect - 2-8 yo - <2cm - Cortex
63
What is the outlook for Fibrous Xanthomas? (NOF & FCD)
Spontaneous resolution over 2-4 years
64
What % of children have FCD?
30-40%
65
Where are Fibrous Xanthomas most often found?
90% in tibia or fibula
66
What are the plain film findings for Fibrous Xanthomas?
``` Lytic, ovoid Eccentric Sclerotic boarder Sclerotic when healing Mild on bone scan ```
67
Are Simpe Bone Cysts true neoplasms?
No, they are fluid filled cyst
68
What age group does Simple Bone cyst affect?
3-14 y/o
69
What are the symptoms of Simple Bone Cysts?
They are asymptomatic
70
What is the big risk with Simple Bone cysts?
Pathologic fracture
71
How do you reduce recurrance of Simple Bone Cysts?
Steroid injection into cyst
72
What is the location of Simple Bone Cysts?
Central | 75% in Proximal Humerus or Femur
73
What are the plain film findings for Simple Bone Cysts?
Geographic, Lytic. Bone expansion, but not beyond physis. "Fallen Fragment" sign with fracture
74
A cystic blood filled cavility tumor is called _
Aneurysmal Bone Cyst
75
What age group does Aneurysmal Bone Cyst affect?
5-20
76
What is the big risk o Aneurysmal Bone Cyst. What is the recurrence rate?
Pathologic Fracture. Recurrance high
77
What is the treatment for Aneurysmal Bone cyst?
Surgery
78
What is the location for Aneurysmal Bone Cysts?
Long Tubular Bones Metaphysis/Diaphyseal Posterior arch of spine (painful scoliosis)
79
What are the plain film findings of Aneurysmal Bone Cysts?
``` Expansile Lytic Eccentric Thinned cortex Metaphysis/Diaphysis ```
80
What is the only benign tumor to cross growth plate?
Aneurysmal Bone Cyst
81
What tumors have a fluid level seen on CT and MRI?
Aneurysmal Bone Cyst Osteosarcomas Giant Cell Tumors Chondroblastomas

Bone Path II (5 decks)

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