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Flashcards in Part 11 Deck (48)
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1
Q

cause of giant cell tumor

A

neoplasm from non-bone formin supporting connective tissue of marrow

2
Q

location of GCT

A

long bones

3
Q

what is the most common benign tumor in the sacrum?

A

GCT

4
Q

findings for GCT

A
geographic, eccentric, metaphyseal
subarticular
expansion
soap bubble or purely lytic
cortical thinning
5
Q

age/gender of GCT

A

20-40

male

6
Q

clinical features of GCT

A
localized pain (aching)
restricted joint motion
7
Q

treatment/prognosis of GCT

A

10% 5 year survival if malignant
surgical curretage with liquid nitrogen freezing
bone packing or grafting
recurrence rate of 12-50%

8
Q

cause of solitary osteochondroma

A

unknown

displaced cartilage from the physis

9
Q

location of solitary osteocondrooma

A

femur and tibia (metaphysis)
flat bones
bones with enchondral ossification

10
Q

age/gender of solitary osteochondroma

A

<20

male

11
Q

findings for solitary osteochondroma

A

cortex and spongiosa blend with host bone
growth at angle toward midshaft
coathanger exostosis

12
Q

clinical features of solitary osteochondroma

A
asymptomatic MC
unless they disturb nerves or vessels
painless hard mass
pain from fracture
cord compression with spinal lesions
obstructive uropathy from pelvic tumor
pain and new growth may be malignant
13
Q

treatment/prognosis of solitary osteochondroma

A

remove if affecting patient

otherwise leave it alone

14
Q

cause of hereditary multiple exostosis

A

inherited autosomal dominant

15
Q

location of hereditary multiple exostosis

A

metaphysis of long bones

multiple, bilateral

16
Q

age/gender for hereditary multiple exostosis

A

2-10

male

17
Q

findings for hereditary multiple exostosis

A
cortex and spongiosa continuous with host bone
short 4th &amp; 5th metacarpals
supernumary fingers and toes
madelung/bayonnet deformity
disproportionate shortening of extremity
18
Q

clinical for hereditary multiple exostosis

A

few to 100, average of 10
painless hard masses around joint
cord compression of obsrctive uropathy possible
5-20% malignant transformation

19
Q

treatment/prognosis of hereditary multiple exostosis

A

remove if affecting patient

otherwise leave alone

20
Q

cause of a solitary bone cyst

A

non-neoplastic fluid filled cavity lined with fibrous tissues

21
Q

location of solitary bone cyst

A

proximal humerus
femur, talus
fibula, calcaneal neck

22
Q

age/gender of solitary bone cyst

A

3-14

male

23
Q

findings of solitary bone cyst

A
metaphyseal adjacent to grwoth plate
central oval radiolucency, long axis parallel to host bone
endoseal scalloping
truncated cone appearance
fallen fragment sign
24
Q

clinical of solitary bone cyst

A

asymptomatic unless fractured

25
Q

treatment/prognosis of solitary bone cyst

A

spontaneous regression in some
surgical curettage and bone chip
recurrence rate of 30-40%
most effective treatment is injection of steroids

26
Q

cause of aneurysmal bone cyst

A

non-neoplastic expansile lesion containing thin-walled, blood filled cystic cavities

27
Q

location of ABC

A

spine (neural arch)
long bones
flat bones

28
Q

age/gender of ABC

A

10-30 (20 average)

female

29
Q

findings of ABC

A

lytic and eccentric metaphysis
expansile ballooning lesion
rapid progression of 6 weeks to 3 months
almost invisible thin cortex

30
Q

clinical of ABC

A

acute onset of pain with increased severity over 6-12 weeks
history of trauma
neurologic with spinal involvement
pathologic fractures

31
Q

treatment/prognosis of ABC

A

surgical curretage and bone chip therapy with possible recurrance
radiation therapy may be used for some lesions, especially in the spine

32
Q

cause of osteoblastoma

A

rare benign growth with unlimited growth potential

33
Q

location of osteoblastoma

A

spine (posterior arches)
long bones
small bones of hands and feet

34
Q

age/gender of osteoblastoma

A

10-20

male

35
Q

findings of osteoblastoma

A

resembles osteoid osteoma, except >2cm
radiolucent and expansile
osteoid matrix
long bones (progressive expansile lesion)

36
Q

clinical of osteoblastoma

A

dull pain with insidious onset, worse at night

painful scoliosis

37
Q

treatment/prognosis of osteoblastoma

A

small lesions treated by excision or curettage
~5% recurrence rate
spinal lesions undergo radiation

38
Q

cause of osteoid osteoma

A

benign skeletal lesion composed of osteoid and woven bone

39
Q

location of osteoid osteoma

A

metaphysis/diaphysis of long bones
spine (posterior elements of lower thoracics and upper lumbars
painful scoliosis

40
Q

age/gender of osteoid osteoma

A

10-25

male

41
Q

findings of osteoid osteoma

A

radiolucent nidus <1cm

cortical: nidus in cortex, fusiform coritcal thickening with 1 cm radiolucent area
cancellous: may be difficult to identify with delay index of 4months-5 years due to little reactive scoliosis

42
Q

clinical of osteoid osteoma

A

tender to touch and pressure
local pain weeks to years, worse at night, decreased by activity
salicylates relieve pain in 75-90%

43
Q

labs of osteoid osteoma

A
bone scan (double density sign)
CT: precise location of nidus
angiography: nidus with intense circumscribed blush in early arterial phase
44
Q

treatment/prognosis of osteoid osteoma

A

complete surgical excision of nidus
little change of recurrence
vertebral body lesions may be irradiated

45
Q

cause of osteoma

A

membranous bone creating a benign tumor

46
Q

location of osteoma

A

paranasal sinuses
inner/outer table of calvarium
may be mandible or nasal bones

47
Q

findings of osteoma

A

well circumscribed round extremity dense lesion

~2cm in size

48
Q

clinical of osteoma

A

associated with Gardner’s syndrome