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Flashcards in Bone Pathology Deck (17)
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1

What does NIRDS stand for?

  • N: Neoplastic
  • I: Inflammatory/Infectious/Idiopathic
  • R: Reactive
  • D: Developmental
  • S: Systemic

2

What are some Neoplastic Benign Pathologies?

  • Osteoma
  • Osteoid Osteoma
  • Ossifying Fibroma (BFOL)
  • Chondroma
  • Chondromyxoid Fibroma
  • Desmoplastic Fibroma
  • Central Hemangioma

3

What are some Neoplastic Malignant Pathologies?

  • Osteosarcoma
  • Chdondrosarcoma
  • Ewing Sarcoma
  • Multiple Myeloma
  • Langerhands Cell Histiocytosis
  • Metastatic Disease

4

What are some Inflammatory/Infectious/Idiopathic Pathologies?

  • Osteomyelitis
  • Osteoradionecrosis (ORN)
  • Osteonecrosis of the jaw (ONJ)
  • Paget's Disease
  • Idiopathic Osteosclerosis
  • Idiopathic Bone Cavity

5

What are some Reactive Pathologies?

  • Central Giant Cell Lesion
  • Aneurysmal Bone Cyst
  • Cemento-Osseous Dysplasias

6

What are some Developmental Pathologies?

  • Osteogenesis Imperfecta
  • Cleidocranial Dysplasia
  • Cherubism
  • Fibrous Dysplasia
  • Osteopetrosis

7

What is an example of Systemic Pathology?

Hyperparathyroidism

8

What is a Focal Osteoporotic Marrow Defect?

  • Not a pathologic Process - etiology unknown
  • Area of hematopoietic marrow large enough to note on imagin
  • Asymtomatic, incidental finding
  • A few millimeters to several centimeters
  • Somewhat ill-defined radiolucency containing fine trabeculations

9

Where are Focal Osteoporotic Marrow Defects usually found?

  • >75% female
  • 70% posteiror mandible, often edentulous area - may occur elsewhere (skull)
  • Histology: Normal Hematopoietic Bone
  • Treatment: None necessary, other than possibly incisional biopsy ro rule out pathology

10

What is a Stafne Defect?

  • AKA static bone cyst (not a true cyst)
  • Described by Safne in 1942
  • Focal concavity on lingual of mandible
  • Classically, radiolucency located below mandibular canal, between molars and angle of mandible
  • May be located in anterior mandible
  • Most patients are male

11

What is the treatment for Stafne Bone Defect?

  • No treatment necessary; biopsy to rule out other pathology
  • May exhibit slow growth over time (not necessarily "static")
  • Developmental defect, but ot congenital 
  • Usually seen in middle age to older adults
  • Defects usually contains salivary gland tissue (submandibular), but also reports of muscle adipose tissue, vascular tissue, lymphoid tissue, etc

12

What are the main culprits in the pathology of Osteomyelitis?

  • Bacterial Infection most commonly
  • Dental Portal
  • Mixed flora - Staph aureus, Strep, Actino; also may be mycobacterial, fungal, or viral
  • Inflammatory Process
  • Medullary &/or cortical bone
  • Extends away from initial site of involvement

13

How do you differentiate between acute and chronic Osteomyelitis?

  • Acute (<1 month)
  • Chroni (>1 month)
  • Suppurative
  • Diffuse sclerosing
  • Focal sclerosing
  • Osteomyelitits with proliferative periosititis (Garre's)
  • SAPHO syndrome: synovitis, acne, pustulosis, hyperososis, osteitis

14

What is the treatment for Osteomyelitis?

  • Identify cause and treat
  • Prevent acute-to-chronic transition
  • Culture & antibiotics sensitivity testing (3 culture tubes)
  • Anerobic
  • Aerobic
  • Gram stain
  • Order/set/OMFS/wound culture (1 & 3)
  • I & D, surgical debridment
  • Antibiotics (oral vs IV)

15

What is Osteomyelitis with Proliferative Periositits also known as?

  • AKA Garre's osteomyelitis - Garre was a German physician who reported on osteomyelitis in 1893. He had no pathologic speciments for microscopic examination and did not mention a periosteal reaction in his original paper. Roentgen did not discover X-rays until 1895
  • MEan age of 13 years (children and young aduults)
  • Radiopaque laminations (onion-skinning)
  • Most cases are due to periapical inflammatory disease

16

What are Bisphosphonates used to treat?

  • Symtomatic osteolytic lesions
  • Multiple Myeloma
  • Mets of solid tumors
  • Paget's disease of bone
  • Prevention/progressionof osteoporosis
  • Bisphosphotnate-related osteonecrosis (BRON, BRONJ)

17