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Skel rad 4

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the most common benign bone tumor osteochondroma
the most common bone malignancy metastatic disease
the most common benign bone tumor of the spine hemangioma
the most common benign bone tumor of the ribs fibrous dysplasia
the most common benign bone tumor of the hands and feet enchondroma
the most common primary bone malignancy osteosarcoma (multiple myeloma)
3 ways mets becomes established in bone 1) tumor embolim via vascular circulation, 2) direct extension, 3) retrograde venous blood flow
cancer's that frequently metastasize bone breast, colon, prostate, lung, stomach, bladder, uterus, rectum, kidney, thyroid
what population are bone metastasis and where do they develop? elderly..., red bone marrow, typically proximal to elbows and knees..it's often multiple
bone metastasis are primarily osteo_____; when do they show up on x-ray? lyric; xray after bones destructed 30-50%
clinical features of bone metastasis pain, neurological symptom, hypercalcemia
types of bone metastasis 1) osteolytic 70%, osteoblastic 20%, mixed 10% (most mixed, but only 10% balanced
What may help you to see rib metastases better? Extrapleural sign... looking for more obvious soft tissue mass may be easier to see than bone lesion
osteolytic metastases commonly seen in ribs, spine (vertebra destruction, missing pedicle, path compression fx=>vertebra plana
missing pedicle sign also known as... winking owl sx (vertebral body also affected, but shows up better b/c cortical to cancellous bone ratio)
what are DDX's for missing pedicle? Agenesis, Lytic mets, Osteoblastoma, ABC, Neurofibroma
osteoporotic compression fracture vs mets(path comp fx)??? Compression fx:MRI shows NORMAL marrow/HIGH signal on T1 but.. Path comp fx: MRI shows LOW marrow signal... both high on T2
What 2 primary cancers cause EXPANSILE mets? renal cell (b/c soap bubbly and expansile) and thyroid carcinoma
What 2 primary cancers cause ARCAL mets? renal cell and lung carcinoma
Most common cause of osteoblastic mets? what else? m/c: prostate, also treated breast, and bladder cancer
DDX's for ivory vertebra? Hosdgkins lymphoma metastatic to bone (white & anterior scalloped), Osteoblastic metastasis (white & compressed), Pagets disease (white & big)
Potential imaging for mets? plain film, bone scan, MRI, CT (pot w/ biopsy)
sensititvity for marrow destruction plain film 30-50%, bone scan2-5%, MRI 1-2%
when a patient has hx of malignancy and bone pain look for? Mets
most common PRIMARY bone malignancy in adults? multiple myeloma
most common PRIMARY bone malignancy in children?/ 2nd most common bone malignancy? osteosarcoma
3rd most common primary bone malignancy? chondrosarcoma
Created by: abva