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ChiroBoards2: Tumors

ChiroBoards2: Malignant and Benign

QuestionAnswer
m/c bbt of the appendicular skeleton = osteochondrom
shapes of osteochondromas pedunculated (coat-hanger exostosis) or sessile (broad band extensions)
Coat hanger exostosis and cauliflower-like describes what? pedunculated tumors
Multiple osteochondromas = Hereditary multiple exostosis
% of malignant osteochondromas in HME? 20%
Unicameral bone cyst, aka = Simple bone cyst
associated with fallen fragment sign = unicameral bone cyst
Where are simple bone cysts located? diaphyseal/metaphyseal = centrally located
simple bone cyst age group less than 20yoa
Diaphyseal/metaphyseal; ECCENTRICALLY locate Aneurysmal bone cyst
ABC age group = less than 2yoa
Epiphyseal/metaphyseal location, 20-40yo; 20% of the time quasi-malignant. soap bubble appearance Giant cell tumor
Night pain relieved by asprin Osteoid Osteoma
Radiolucent central nidus (<2cm) with severe reactive sclerosis Osteoid Osteoma
Night pain relieved by asprin and appears like an osteoid osteoma, nidus (>2cm) Brodie's abscess
Brodie's abscess aka... chronic osteomyelitis
Most common BBT of the hand, may have a stippled appearance enchondroma
multiple enchondromas = Ollier's Disease
% of malignancy in Ollier's 10-50% rate of malignant degeneration (highest rate of malignancy in BBT)
multiple enchondromas with soft tissue calcification is known as what syndrome? Maffucci's Syndrome
Most common BBT of the spine Hemangiomas
Will appear with vertical striations and have a corduroy cloth appearance = Hemangiomas
Bone island; round or oblong radiopaque lesion Enostoma
Multiple bone islands Osteopoikilosis
Most common BBT to affect skull = osteoma
Most commonly found in the frontal sinus and best seen on the Caldwell projection. osteoma
"rind sign" assoic. with Fibrous dysplasia
Saber shin tibia, sheppard's crook, ground glass appearance, cafe au lait = Fibrous dysplasia
coast of main appearance lesion Fibrous dysplasia
Pt, may present with scoliosis, cervical kyphosis, verterbral body scalloping with IVF enlargement, and cafe au lait spots Neurofibromatosis
Cast of California appearance lesion Neurofibromatosis
Most common primary malignancy of bone = MM
Plasma cell sarcoma, aka.= MM
punched out lesions, vertebral plana, and associated with rain drop skull MM
Multiple myeloma labs/special tests = (5 ) 1) M spike on immunoelectrophoresis; 2) Reversal of Albumin/Globulin Ratio; 3) Bence-Jones Proteinuria; 4) elevated ER, Bone scan = Cold
most common malignant tumor of bone metastatic dx (lytic and blastic)
Over age of 40, recent unexplained weight loss, skeletal pain is worse at night. Affected bones are darker in color with moth eaten(extremities) or permeative (spine( pattern of destruction = Lytic Metastasis
"Eats" away pedicle from bone. Has a "swiss cheese" appearance in the skull. = Lytic metastasis
Lab/Special tests for Lytic metastasis = (2) Alk phos elevated; Bone scan is hot
Over 40 yo, ivory white vertebrae; most common cause is from prostatic carcinoma = Blastic metastasis
Most common form of metastasis in ages 20-40 hodgkin's dx
Bone may become more radiopaque in color, ivory white vertebrae with anterior body scalloping = hodgkin's dx
Uni-lateral hilar lymphadenopathy in white males seen on PA chest view with this malignancy = hodgkin's dx
reed sternberg cells in = hodgkin's dx
4 stages of Paget's = Lytic or destructive, then combined, then sclerotic, then malignant (osteosarcoma)
picture frame vertebrae = in Paget's
Most common malignancy found in children = osteosarcoma (age 10-30)
causes a periosteal rxn that is spiculated/radiating/sunburst in appearance. pt. is 10-30 years old = osteosarcoma
causes a periosteal rxn that is spiculated/radiating/sunburst in appearance. pt. is over 40 years old = Chondrosarcoma and fibrosarcoma
Found in kids/teens, most commonly in diaphysis of long bones. Permeative lesion causes a multi-paralleled onion skin (laminated) perosteal reaction. = Ewing's Sarcoma
Bone expansion, codman's triangle, and saucerization are all seen in Ewing's Sarcoma
Aberrant notochordal cell tumor = Chordoma
where are chordoma's typically found? Sacrum (1st), and Skull (2nd)
Created by: bglasman on 2012-03-13



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