Quiz 2 part II

Question 1

What is another name for a bone island?

Answer 1

Enstoma

Question 2

Describe an enostoma

Answer 2

Solitary, discrete area of sclerosis. Not a neoplasm!

Question 3

Common locations for enostomas? Age of patient?

Answer 3

Pelvis, sacrum, proximal femur, basically any bone except skull

Any age, m/c adults

Question 4

How fast do enstomas grow?

Answer 4

They don’t grow or do so very slowly!

Question 5

Plain film findings of enostoma?

Answer 5

Ovoid or round with sharp margins that is homogenously dense.

Often has a “brush border”

Metaphysis or epiphysis

Question 6

Which benign bone tumor has a clear, lytic center surrounded by sclerosis?

Answer 6

Osteoid Osteoma

The lytic center is called a “nidus”

Question 7

How do you tell the difference between a enostoma (bone island) from osteoblastic mets?

Answer 7

Ultimately will have to do a bone scan, but a brush border indicates enostoma

Question 8

What is a common characteristic of osteoid osteomas?

Answer 8

Pain! Hardly ever are discovered incidental.

Pain gets increasingly severe and is wore at night

Question 9

Common age range of patients with osteoid Osteoma?

Answer 9

10-25

Question 10

What are two benign tumors that typically cause pain?

Answer 10

GCT and osteoid osteoma

Question 11

Where is the m/c location for osteoid osteoma?

Answer 11

50% in femur and tibia

20% phalanges

10% spine, mostly neural arch

Question 12

Where in bone is it m/c for osteoid osteoma to form?

Answer 12

Cortex, although they can occur cancellous and sub periosteal bone

Question 13

Plain film findings for osteoid osteoma?

Answer 13

Lucent nidus (>1cm) surrounded by reactive sclerosis

Question 14

Treatment for osteoid osteoma?

Answer 14

Must remove nidus entirely or will most likely recur

Question 15

What is the go to imaging for osteoid osteoma?

Answer 15

Plain film- can identify 75% of the time

Question 16

3 causes of painful scoliosis

Answer 16

Osteoid osteoma

Aneurysmal bone cyst (expansile lytic lesion)

Osteoblastoma

Question 17

Which 5 benign tumors cause pain?

Answer 17

GCT
Osteoid osteoma
Osteoblastoma
Chondroblastoma
Aneurysmal bone cyst

Question 18

Which benign tumor is a sclerotic lesion found in the skull or sinuses?

Answer 18

Osteoma

Question 19

Which benign tumor should be DDx’d against Paget’s disease?

Answer 19

Hemangioma

Question 20

Which benign tumor should be DDx’d against osteoblastoma and brodie’s abscess?

Answer 20

Osteoid osteoma

Question 21

Which benign tumor, if close to the axial skeleton, should be DDx’d against chondrosarcoma?

Answer 21

Enchondroma

Question 22

What is another name for enostoma?

Answer 22

Bone island

Question 23

Where can bone islands form?

Answer 23

Anywhere except the skull

Question 24

Which benign tumor has a cartilagenous cap?

Answer 24

Osteochondroma

Question 25

Which two benign tumors have a nidus?

Answer 25

Osteoid osteoma | Osteoblastoma

Question 26

Which benign tumor is characterized as being within the cortex, small, eccentric with a sclerotic margin?

Answer 26

NOF/FCD

Question 27

Should you refer out for a simple bone cyst?

Answer 27

Yes indeed

Question 28

Should you refer out for an osteoma?

Answer 28

No, unless it is disrupting a sinus then maybe

Question 29

What is the malignant potential of osteochondroma?

Answer 29

``` Single lesion 1% Multiple lesion (MHE) 20% ```

Question 30

What is the malignancy potential for enchondroma?

Answer 30

Single lesion 1% | Multiple lesions 25-50%

Question 31

What is the most common benign tumor of the patella?

Answer 31

GCT

Question 32

What % of GCT are purely lytic?

Answer 32

60% 40% will have soap bubbly appearance

Question 33

M/c locations for osteochondroma?

Answer 33

85% in femur, humerus or tibia

Question 34

Osteochondroma and growth plate closure?

Answer 34

Growth should cease when plate closes

Question 35

What is the m/c benign tumor of the spine?

Answer 35

Hemangioma

Question 36

T or F: path fx are common with hemangiomas

Answer 36

False AF

Question 37

T or F: vertebral body expansion is common with hemangiomas

Answer 37

False AF

Question 38

Hemangiomas in soft tissue usually contain _______

Answer 38

Phelobiths

Question 39

What is Gardners syndrome (triad) ?

Answer 39

Multiple osteomas Colonic polyps Soft tissue fibromas

Question 40

3 DDx for enostoma?

Answer 40

Osteoblastic mets Osteoid osteoma Osteoma

Question 41

M/c location for osteoblastoma?

Answer 41

40% are in neural arch of spine 30% long bone metaph, diaph 30% hands, feet, skull, face

Question 42

Which painful benign bone tumor is relieved by aspirin?

Answer 42

Osteoid osteoma

Question 43

Are osteobalstomas mostly lytic or blastic?

Answer 43

Lytic!

Question 44

What is the 2nd most common benign tumor?

Answer 44

Enchondroma

Question 45

Most common location for enchondroma?

Answer 45

50% Phalanges (hands and feet) 50% femur, tibia, humerus, ribs

Question 46

Enchondroma appearance?

Answer 46

``` Geographic Expansile Thinned cortex with scalloping Most are central Calcification in 50% No periosteal reaction, no ST mass ```

Question 47

What is Ollier's disease?

Answer 47

Multiple enchondromatosis

Question 48

What is Maffucci's syndrome?

Answer 48

Multiple enchondromatosis with ST hemangiomas (phleboliths), malignant transformation up to 25%

Question 49

Chondroblastoma and growth plate closure

Answer 49

Chondroblastomas are usually seen before growth plate closure

Question 50

Location of chondroblastoma?

Answer 50

Epiphyseal or apophyseal

Question 51

Which two tumors can be found in the epiphysis?

Answer 51

GCT | Chondroblastoma

Question 52

One main plain film finding that is different between GCT and chondroblastoma?

Answer 52

Chondroblastoma have calcifications 50% of the time. GCT do not.

Question 53

Most common location for Chondromyxoid fibroma

Answer 53

50% in tibia

Question 54

Location difference between FCD and NOF?

Answer 54

FCD stays in cortex | NOF extends into medullary cavity

Question 55

T or F: NOF is more likely to be found in a 15 year old than FCD?

Answer 55

True AF

Question 56

Most common location for NOF/FCD?

Answer 56

90% in tibia or fibula

Question 57

Most common location for simple bone cyst?

Answer 57

75% in proximal humerus or femur

Question 58

Treatment for simple bone cyst?

Answer 58

Surgery d/t high fracture rate

Question 59

Primary symptom of aneurysmal bone cyst?

Answer 59

Acute onset of pain with rapid increase in severity

Question 60

What is the most common benign tumor of the clavicle?

Answer 60

ABC

Question 61

What is the only benign tumor to cross the growth plate?

Answer 61

ABC

Question 62

What is the rarest primary bone tumor? Characteristics?

Answer 62

Intraosseous lipoma Lytic, geographic, sclerotic border