Bone tumours

Question 1

Osteoid osteoma

Answer 1

M>F
Commonest between 10 and 25 years
Severe pain that responds to NSAIDS
Femur and tibia usually affected
Lesion affects cortex and radiologically consists of a lucent centre surrounded by reactive sclerosis
Usually smaller than 1cm

Question 2

Chondroma

Answer 2

Endochondroma are central lesions that may cause cortical thinning
Ecchondroma project beyond the cortex
May cause pathological fracture
Rarely found in large bones

Question 3

Osteochondroma

Answer 3

Usually occurs on the surface of a metaphysis (usually femur, proximal humerus or tibia)
Pedunculated lesion arising from metaphysis
Long standing lesions
Do not grow once skeletal maturity reached

Question 4

Bone cyst

Answer 4

Commonest in adolescent boys
Occur in proximal femur and humerus
May result in pathological fracture
Does not affect growth plate
On imaging appears as ovoid radiolucent area with surrounding cortical thinning

Question 5

Giant cell tumour of bone

Answer 5

Most are benign.
On imaging, these lesions have an epiphyseal location and have a characteristic ‘soap bubble’ appearance.

Question 6

Ewings sarcoma

Answer 6

Ewings sarcomas typically affect long bones and typically occurs during the first two decades of life. Sometimes raised ESR - poor prognosis
Onion skin appearance on imaging

Question 7

Osteosarcoma

Answer 7

Most common
Males in second decade
They typically present as a painful expanding mass affecting a long bone such as the femur, in close proximity to a joint.
Mixed sclerotic and lucent zones in the metaphysis bone formation within the tumour is often visible.