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NYCC Bone & Joint
Benign Tumors
| Question | Answer |
|---|---|
| MC Benign tumor of the extremities | Osteochondroma |
| 50% of all benign bone tumors | Osteochondroma |
| MC age/gender of OSTEOCHONDROMA? | <20, male |
| Symptoms of an OSTEOCHONDROMA? | Painless, hard mass; stalk may fracture Usually asymptomatic (often unreported) |
| If an OSTEOCHONDROMA becomes malignant what is it called? | Chondrosarcoma |
| What are the indications to remove an OSTEOCHONDROMA? | >5cm, painful Cartilage cap should be <1cm...if >3cm at risk for chondrosarc |
| Where are OSTEOCHONDROMAS often found? | Metaphysis Femur, humerus, tibia, pelvis, ribs, scap |
| What imaging findings will present with an OSTEOCHONDROMA? | SESSILE: Cartilage cap (uncommon) Lucent when en face (wide, broad metaphysis) PEDUNCULATED (coat hanger or cauliflower like) - calcified cap; projects away from joint Lucent when en face Often found at LUSCHKA's TUBERCLE (on scap) |
| What % of HME transform into malignancy? | 5-25% to chondrosarc |
| What age to people present with HME? | 2-10yrs it is discovered |
| What symptoms will patients present with if they have HME? | Multiple painless osteochondromas, often bilateral |
| What are the MC locations of HME? | Knee, ankle, shoulder, wrist, MADELUNG'S DEFORMITY |
| What would HME appear like on radiograph? | "Brahma Bull" appearance on greater trochanter of femur (very wide metaphysis) |
| 2 types of hemangiomas? And locations for each? Which is the most common? | Cavernous [skull and spine- lower T, upper L] & Capillary [ribs, pelvis, long bones] cavernous is MC 75% |
| What is the MC benign tumor of the spine? | HEMANGIOMA |
| Age/gender of patients with HEMANGIOMAS? | Female >40 |
| Symptoms associated with HEMANGIOMAs | Asymptomatic; rare expansion causes neurological findings; paravertebral swelling |
| DDX for HEMANGIOMA type lesions? | Pagets, Osteoporosis, Hemangioma |
| What part of the spine is often affected by HEMANGIOMAs? | vertebral body (10-15% in arch) |
| Radiographic/MRI/CT findings for HEMANGIOMAs | Corduroy cloth; sand dollar (sunburst, spoke-wheel); polka dot appearance on CT Paravertebral swelling Bright on both T1 & T2 weighted images DT high fat content |
| ST Hemangioma is AKA? Where are they found? | Phleboliths; pelvic brim |
| Symptoms of an OSTEOMA? | Asymptomatic. Will have blocked sinuses --> sinusitis |
| Diagnostic criteria for an OSTEOMA? | Hemartoma = normal cells in normal location just more of them |
| Common locations of OSTEOMAS | Sinus, mandible, skull, tibia |
| Radiographic finding of OSTEOMA | Osteosclerotic - arrises from surface of bone |
| What is the triad for GARDNER'S SYNDROME? | 1) Multiple osteomas; 2) Premalignant colon polyps; 3) Soft tissue fibromas |
| Another name for Bone Island? | Enostoma/Enostosis |
| ENOSTOMAS can be found in what age groups? and what are the symptoms? | any age, asymptomatic |
| Hemartoma can be associated with what two benign tumors? | osteoma & enostoma |
| Common locations for ENOSTOMAS? | Epiphysis & metaphysis; medullary space; pelvis (esp ilium); proximal femur. |
| Radiographic findings for Ensotomas? | Usually solitary round or oval radiodensity with RADIATING BRUSH BORDER. Occasionally warm on bone scan b/c can be growing. |
| Giant Bone Island measures what? | >2cm |
| DDX BI with Osteblastic Mets Pain # of Lesions Bone Scan Age Change in Size | BI: Pain = none; OM = yes BI: # = Solitary; OM; multiple BI: BS = can be warm; OM = hot BI: Age = any; OM = >45 BI: Size chg = occasionally; OM = yes |
| Age/gender for OSTEOID OSTEOMA | 10-25 Male |
| Symptoms of OSTEOID OSTEOMA | Severe pain, worse at night (incr prostaglandins) relieved by aspirin. May get painful scoliosis if in spine. |
| What side of the scoliosis is OSTEOID OSTEOMA on? | Concave side |
| DDX for OSTEOID OSTEOMA-like tumor | 1) Brodie's Abscess 2) Osteoblastoma 3) Stress fx |
| MC Locations of OSTEOID OSTEOMAS | Metaphysis, Diaphysis; Femur & Tibia (50%); 10% spine (posterior elements) |
| Radiographic findings of an OSTEOID OSTEOMA | Central radiolucent nidus (<1cm); sclerotic border w/ central calcified fleck; solid periosteal bone reaction; cortical based – thickened. HOT bone scan (double density sign) |
| Preferred type of imaging to dx OSTEOID OSTEOMA? | CT |
| MC benign tumor of hand and foot? | Enchondroma |
Created by:
mrw2013
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