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Flashcards in Tutoring sessions 2 Deck (17)
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1

MRI with contrast

malignancy
acute bleed
infection

- anything with increased vascularity

2

MRI without contrast

radiculopathy
ligament tears
osteoma

- not looking for vascular components

3

after MRI what is the next step

biopsy

4

oma

sarcoma

benign - a few exceptions

malignant

5

mulitcentric osteosarcoma

rare
pain
in medullary canal
looks like blastic mets
kids
fatal
labs - alkaline phosphatase
poor prognosis - pulmonary mets - cannonball

6

parosteal osteosarcoma

juxtacortical within periosteum
adults
well differentiated
slow dull pain swelling
posterior distal femur
> 10 cm lobulated broad
becomes larger overtime

ddx - myositis ossificans (caused by trauma) - completely separated from bone and dense in peripherry and shrinks as it gets closer to bone - shrinks over time

7

if something looks aggressive and we look at old films from 10 years ago and it looks aggressive then is it aggressive

no its not

8

secondary osteosarcoma

pagets, poly FD, HME, olliers, radiation, wilms
radium watches
post radiation sarcoma - 15 years later average
pain
liver and spleen toxicity from radiation and tumor

9

extraosseous osteosarcoma

non skeletal bone cancer
affects soft tissue - mc in thigh
adults
likely to mets to the lungs - cannonball mets


ddx - myositis ossificans

10

chondrosarcoma

cartilage cancer
primary - within bone
secondary - malignant transformation
3rd most common primary malignancy in adults
pain and swelling
pelvis, flat bones, and proximal femur
cartilaginous tumor, flocculated

excision best way to get rid of - spreads by direct extension

11

ewings

diaphyseal and diametaphyseal sarcoma in kids
only malignancy that looks like infection
fever, anemia, leukocytosis, high ESR
onion skinning periosteal reaction
rapid, loves femur and pelvis

12

fibrosarcoma

eccentric expansile
metaphyseal collagen malignancy in adults
young - tubular bones around knee
older - flat bones like pelvis
malignant fibrous histiocytoma - undifferentiated pleomorphic sarcoma
secondary from - pagets, post radiation, chronic osteomyelitis
mets to the liver and lung later
high soft tissue mass
treatment - amputation

13

chordoma

rare notochord remnant
old adults
sacrococcygeal - MC 50%
resection is best therapy
crosses disc and spread to adjacent segments - sounds like infection but not

14

if you see a lit up vertebral body on xray think..

pagets
blastic mets
hodgkins lymphoma

15

low intensity on t1 indicates what

high intensity on t2 indicates what

something is invading the marrow

edema in the bone

16

skeletal survey

multiple radiographs of different parts of the body

17

see multiple myeloma on xray what is the next steps

lab work
MRI
biopsy