Part 11 Flashcards by Rachael Beverage

cause of giant cell tumor

neoplasm from non-bone formin supporting connective tissue of marrow

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location of GCT

long bones

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what is the most common benign tumor in the sacrum?

GCT

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findings for GCT

geographic, eccentric, metaphyseal
subarticular
expansion
soap bubble or purely lytic
cortical thinning

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age/gender of GCT

20-40

male

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clinical features of GCT

localized pain (aching)
restricted joint motion

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treatment/prognosis of GCT

10% 5 year survival if malignant
surgical curretage with liquid nitrogen freezing
bone packing or grafting
recurrence rate of 12-50%

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cause of solitary osteochondroma

unknown

displaced cartilage from the physis

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location of solitary osteocondrooma

femur and tibia (metaphysis)
flat bones
bones with enchondral ossification

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age/gender of solitary osteochondroma

<20

male

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findings for solitary osteochondroma

cortex and spongiosa blend with host bone
growth at angle toward midshaft
coathanger exostosis

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clinical features of solitary osteochondroma

asymptomatic MC
unless they disturb nerves or vessels
painless hard mass
pain from fracture
cord compression with spinal lesions
obstructive uropathy from pelvic tumor
pain and new growth may be malignant

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treatment/prognosis of solitary osteochondroma

remove if affecting patient

otherwise leave it alone

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cause of hereditary multiple exostosis

inherited autosomal dominant

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location of hereditary multiple exostosis

metaphysis of long bones

multiple, bilateral

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age/gender for hereditary multiple exostosis

2-10

male

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findings for hereditary multiple exostosis

cortex and spongiosa continuous with host bone
short 4th &amp; 5th metacarpals
supernumary fingers and toes
madelung/bayonnet deformity
disproportionate shortening of extremity

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clinical for hereditary multiple exostosis

few to 100, average of 10
painless hard masses around joint
cord compression of obsrctive uropathy possible
5-20% malignant transformation

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treatment/prognosis of hereditary multiple exostosis

remove if affecting patient

otherwise leave alone

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cause of a solitary bone cyst

non-neoplastic fluid filled cavity lined with fibrous tissues

location of solitary bone cyst

proximal humerus
femur, talus
fibula, calcaneal neck

age/gender of solitary bone cyst

3-14

male

findings of solitary bone cyst

metaphyseal adjacent to grwoth plate
central oval radiolucency, long axis parallel to host bone
endoseal scalloping
truncated cone appearance
fallen fragment sign

clinical of solitary bone cyst

asymptomatic unless fractured

treatment/prognosis of solitary bone cyst

spontaneous regression in some surgical curettage and bone chip recurrence rate of 30-40% most effective treatment is injection of steroids

cause of aneurysmal bone cyst

non-neoplastic expansile lesion containing thin-walled, blood filled cystic cavities

location of ABC

spine (neural arch) long bones flat bones

age/gender of ABC

10-30 (20 average) | female

findings of ABC

lytic and eccentric metaphysis expansile ballooning lesion rapid progression of 6 weeks to 3 months almost invisible thin cortex

clinical of ABC

acute onset of pain with increased severity over 6-12 weeks history of trauma neurologic with spinal involvement pathologic fractures

treatment/prognosis of ABC

surgical curretage and bone chip therapy with possible recurrance radiation therapy may be used for some lesions, especially in the spine

cause of osteoblastoma

rare benign growth with unlimited growth potential

location of osteoblastoma

spine (posterior arches) long bones small bones of hands and feet

age/gender of osteoblastoma

10-20 | male

findings of osteoblastoma

resembles osteoid osteoma, except >2cm radiolucent and expansile osteoid matrix long bones (progressive expansile lesion)

clinical of osteoblastoma

dull pain with insidious onset, worse at night | painful scoliosis

treatment/prognosis of osteoblastoma

small lesions treated by excision or curettage ~5% recurrence rate spinal lesions undergo radiation

cause of osteoid osteoma

benign skeletal lesion composed of osteoid and woven bone

location of osteoid osteoma

metaphysis/diaphysis of long bones spine (posterior elements of lower thoracics and upper lumbars painful scoliosis

age/gender of osteoid osteoma

10-25 | male

findings of osteoid osteoma

radiolucent nidus <1cm cortical: nidus in cortex, fusiform coritcal thickening with 1 cm radiolucent area cancellous: may be difficult to identify with delay index of 4months-5 years due to little reactive scoliosis

clinical of osteoid osteoma

tender to touch and pressure local pain weeks to years, worse at night, decreased by activity salicylates relieve pain in 75-90%

labs of osteoid osteoma

``` bone scan (double density sign) CT: precise location of nidus angiography: nidus with intense circumscribed blush in early arterial phase ```

treatment/prognosis of osteoid osteoma

complete surgical excision of nidus little change of recurrence vertebral body lesions may be irradiated

cause of osteoma

membranous bone creating a benign tumor

location of osteoma

paranasal sinuses inner/outer table of calvarium may be mandible or nasal bones

findings of osteoma

well circumscribed round extremity dense lesion | ~2cm in size

clinical of osteoma

associated with Gardner's syndrome