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MSK > Trigger - Bone Disease > Flashcards

Trigger - Bone Disease Flashcards

1
Q

where are places that bone metastases may originate from

A

breasts
prostate
lungs
thyroid
kidneys

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2
Q

what do you order to assess if bone cancer has metastasized to the thorax

A

CT

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3
Q

If you are planning to biopsy a bone tumor, what imaging would you order

A

MRI w contrast!!

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4
Q

benign bone tumor originating from osteoblasts

A

osteoid osteoma

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5
Q

what is the MC location for osteoid osteoma

A

femur!

tibial and humeral shaft also common

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6
Q

this cancer presents with pain due to a “nidus” secreting prostaglandins

A

osteoid osteoma

osteoblastoma

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7
Q

worse with activity and ETOH!!
improves with NSAIDs and ASA

A

osteoid osteoma

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8
Q

You have a 25M patient with a limp and referred pain to their knee. Their dull, aching, pain is worse at night, but it gets better if he takes an aspirin. The doctor says he has a benign bone tumor that builds bone. He forgot the name of it. Although this is an atypical presentation of it, the bone tumor you suspect is…

A

osteoid osteoma

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9
Q

presents with hip pain with walking that has caused a limp. Pain radiates to the knee and is made better with aspirin or NSAIDs.

A

osteoid osteoma

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10
Q

radio-opaque area of a bone that is described as a “bell” surrounded by sclerotic/calcified bone

A

Osteoid osteoma

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11
Q

What are indications for ordering a CT w IV contrast after visualizing a osteoid osteoma on XR

A
  • XR appears abnormal but nidus isnt visible
  • residual or recurent tumor present
  • tumor located in critical area (spine or femoral neck)
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12
Q

A 19y/o M patient presents with constant dull, aching pain in his left thigh. He reports its worse at night and wakes him from sleep and improves with NSAIDs or aspirin. you order an XR which is clear. what other scans could you order and what would you see

A
  • CT w/IV contrast (WITHHHH, doesnt say what youd see)
  • radionuclide scanning aka bone scan (double density sign)
  • MRI w/gadolinium (only if cant get CT either)

this is osteoid osteoma

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13
Q

double density sign on bone scan

A

osteoid osteoma

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14
Q

What is the treatment & prognosis for osteoid osteoma

A
  1. NSAIDs w serial imaging Q 4-6 mo
  2. if uncontrolled pain, limp or scoliosis occur refer to surgery
  3. untreated (nonsurgical) patients will resolve spontaneously
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15
Q

MC location for this tumor is the posterior column of the spine

spinous processes, lamina, pedicles

A

osteoblastoma

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16
Q

This diagnosis has a Nidus that is >2cm and is NOT relieved w NSAID use

A

osteoblastoma

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17
Q

XR of lesion on the posterior spine shows Well-circumscribed, radiolucent nidus > 2 cm

A

osteoblastoma

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18
Q

CT is indicated in ALL patients dianosed with this disease

A

osteoblastoma

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19
Q

If a patient has a osteoblastoma that extends into the soft tissue, bone marrow and spine. What imaging do you order?

A

MRI

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20
Q

Tx for osteoblastoma

A

surgical resection (curettage and burring followed by bone grafting)

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21
Q

MC solitary benign bone tumor

A

osteochondroma

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22
Q

cartilage capped bony projection on the external surface of a bone

osteocartilaginous exostosis

A

osteochondroma (benign)

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23
Q

MC in the knee or proximal humerus

adjacent to epiphyseal plates… ceases when growth stops

A

osteochondroma

24
Q

Assocaited with HMO which causes a genetic mutation in the tumor suppressor genes EXT1 and EXT 2

A

osteochondroma

hereditary multiple osteochondromas

25
Q

bone spur extending away from a joint

A

osteochondroma

26
Q

A patient with a known osteochondroma comes in for their yearly check up. you note that the tumor has grown, what do you order?

A

MRI

27
Q

benign cartilage forming tumors that develop in the bone marrow of long bones

A

enchodroma

“ENside the bone”

28
Q

MC in the hands and feet

A

enchondromas

29
Q

XR shows centrally located round lesion that is well circumsized with lobulations inside of it. It has a sclerotic border

A

enchondroma

30
Q

MC occurs in the epiphysis of proximal humerus

A

chondroblastoma

31
Q

Small, well-defined lesions with a sclerotic border than may cross the physis/growth plate

A

chondroblastoma

32
Q

what is the management for chondroblastoma

A

curettage and bone grafting

BIOPSY prior to surgery!

33
Q

this disease can lead to benign pulm mets, monitor with CXR or CT w/ con if very sus.

A

chondroblastoma

34
Q

Associated with McCune albright syndrome

A

fibrous dysplasia

35
Q

Varus deformity of the proximal femur, a shepherd’s crook

A

fibrous dysplasia

36
Q

Spongy-like appearance on CT of of the orbits, jaw, and cranial base might suggest

A

fibrous dysplasia

37
Q

ground glass appearance on XR with thin cortical bone and possible bowing

A

fibrous dysplasia

38
Q

Must do a bone scan once this disease is diagnosed

A

fibrous dysplasia

39
Q

what is the management of fibrous dysplasia

A

Curettage and bone grafting (adults only)
IV bisphosphonates

40
Q

can present w facial asymmetry due to hemicranial involveemnt

A

fibrous dysplasia

41
Q

MC in the tibia and fibula for kids and the mandible in adults

A

ossifying fibroma

42
Q

XR shows Cortex thinned with multiple lytic lesions of lucency and well circumscribed intracortical lesions

A

ossifying fibroma

43
Q

MC benign bone lesion in children

A

nonossifuying fibromas

44
Q

Small, well-defined, eccentric, lytic lesions, found in Distal diaphysis/metaphysis, Can have multiple

A

non ossifying fibroma

45
Q

Pathologic fx caused by these may have a fallen leaf or fallen fragment sign.

this disease is typically asymptomatic until the pathologic fracture occurs!!

A

unicameral bone cysts

46
Q

Well-defined cystic lesion at metaphysis or metadiaphysis that generally involved the ENTIRE diameter of the bone!

A

unicameral bone cysts

47
Q

What is the treatment if you are worried about fracture for unicameral bone cysts

A

aspiration w injection of methylprednisolone or bone marrow.

curettage and grafting reserved for very large cysts

48
Q

benign, rapidly growing but destructive cysts filled with blood

A

aneurysmal cyst

49
Q

MC occurs in the tibia and femur

A

aneurysmal bone cysts

50
Q

Aggressive, expansile, lytic metaphyseal lesion with sharp borders and an eggshell sclerotic rhim. has a soap bubble appearance

A

aneurysmal bone cysts

51
Q

MC MALIGNANT bone tumor

A

osteosarcoma

52
Q

XR shows:
moth eaten appearance
Starburst appearance
Codman’s triangle

A

osteosarcoma

53
Q

After the age of 50
MC in Pelvic and shoulder girdles

A

chondrosarcomas

54
Q

XR:
Bony contour is thinned and expanded
Endosteal scalloping
Lesion often > 5 cm

A

chondrosarcoma

55
Q

chromosomal translocation between 11 and 22

A

Ewing Sarcoma

56
Q

XR shows:
Poorly marginated destructive lesion
Onion skin appearance

A

Ewing Sarcoma

MSK (27 decks)

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