Benign Bone Tumors

Question 1

Cortical erosion

Endosteal scalloping

Answer 1

Descrution of cortex by lytic or sclerotic process

Thinnging of cortex by intraosseous process

Question 2

Imaging beyoind X ray

Answer 2

Most definitive is MRI

CT good for cortex

Question 3

Osteochondroma

What is it
Where
Tx

Answer 3

Non-painful in femur or tibia

Metaphysis or diametaphysis from the surface and projects out

Solitary called exostosis

Osteochondromatosis is multiple

Surgical resection IF symptomatic

Question 4

Osteochondroma radiographic

Answer 4

Mushroom

Question 5

Enchondroma

Age
Where in body 
What does it look similar to?
What do you see on film?
Tx

Answer 5

Benign cartilaginous lesion

Younger (10-39)

Hands and feet

Low-grade chondrosarcoma

Stippled calcification, edosteal scalloping ossificiation, expansion of cortex

Surgery if grwoth or fracture

Question 6

Giant cell tumor of bone 
Age
Where 
Histology
Tx

Answer 6

20-40
Epiphysis of long bones around the knee

Multinucleated giant cells in stroma

Fractures common

Surgery or RANKL

Question 7

Osteoid osteoma 
Patho
Where
Population
SSx
Appearance

Answer 7

Half in cortex of tibia or fibula
Small lesions of osteoid and woven bone which have painful swelling

Males under 40

Pain worse at night and relieved by antiinflam

Long bones and vertebrae

Periosteal new bone with central radiolucent nidues

Question 8

Anuerysmal bone cysts
Appearance
IMaging
What is it

Answer 8

Blood filled cystic lesions

Soap bubble appearnce in metaphysis…MRI shows fluid levels

Question 9

Osteochondroma
Age/gender
Locations
Radiograph tx

Answer 9

10-35 yrs and male
Femur/tibia
Exophytic and cartilaginous
Surgery if sx

Question 10

Enchondroma

Age/gender
Locations
Radiograph tx

Answer 10

15-40 yrs
Hands/feet
Stippled calcification with endosteal scalloping

Surgery if sx

Question 11

GCT

Age/gender
Locations
Radiograph tx

Answer 11

20-30 female

Epiphysis of long bones

Eccentric lucency of epiphysis

Surgery and/or denosumab

Question 12

Osteoid osteoma

Age/gender
Locations
Radiograph tx

Answer 12

10-35 male

Tibia/fibula
New bone with radiolucent nidus

NSAIDS and surgery

Question 13

ABC

Age/gender
Locations
Radiograph tx

Answer 13

<30

Metaphysis of long bones

Soap bubbles with spetations and fluid levels

Surgery

Question 14

Most common bone metastases and SREs

Answer 14

Breast and prostate

Pain, fracture, hyperCa, spinal cord compression

Question 15

Prsentation of bone metastasis

Answer 15

Not all cause baine

Weight bearing bones earlier

Worse at night

10% hyperclacemia

Question 16

PLain film
Bone scan
PET
CT/MRI for bone metastasis

Answer 16

Osteolytic not detected well

May miss purely lytic

IDs most lytic but less sensitive to blastic (prostate)

Better for suspicious…MRI good for spinal cord

Question 17

Location of bone matastesis

Answer 17

Axial or promximal long bones

Hands or feet lung cancer only

Question 18

Mechs of bone metastasis

Answer 18

Direct extension

Retrograde venous flow…intra-abdominal spreads to lumbar vert

Tumor emboli involing red marrow

Question 19

Nature of bone metast

Answer 19

Renal and thyroid always lytic (use PET)

Prostate nearly scelrotic (use Bone scan or fim)

Question 20

Lytic bone metastases

Answer 20

Punched-out lucent lesion in proximal femur and inferior pubic ramus

Question 21

Sclerotic bone metastasis

Answer 21

Seen in vertebral bod y