Abos - Orthopaedic Oncology:basic Orthopaedic Tumor Principles:radiographic Examination Pearls

Front 1

What are the five key differential diagnoses for destructive lesions of bone in young patients?

Back 1

Osteosarcoma
Ewing sarcoma
Leukemia/lymphoma
Osteomyelitis
Eosinophilic granuloma

Front 2

What are the five key differential diagnoses for destructive lesions of bone in older patients?

Back 2

Metastases
Myeloma
Lymphoma
Chondrosarcoma
Malignant fibrous histiocytoma (MPH)

Front 3

What are the five key differential diagnoses for processes that affect both sides of a joint?

Back 3

Bone infarcts (x-ray: smoke signal; histology: empty lacunae)
Tuberculosis/coccidioidomycosis (histology: spores, Langerhans’ cells)
Pigmented villonodular synovitis (PVNS; x-ray: lytic)
Gout (histology: tophaceous material)
Rheumatoid arthritis

Front 4

What are the three key differential diagnoses for eccentric metaphyseal x-ray appearance lesions?

Back 4

Nonossifying fibroma (NOF): "bubbly"
Chondrornyxoid tibroma (CMF): "bubbly"
Aneuiysmal bone cyst (ABC): not bubbly

Front 5

What are the six key differential diagnoses for a calcified lesion on the surface of bone?

Back 5

Osteochondroma
Periosteal osteosarcoma
Parosteal osteosarcoma
Myositis ossificans
Periosteal chondroma
Periosteal chondrosarcoma

Front 6

If you see a multiple-lesion process, what are the three most likely etiologies in children <5 years of age?

Back 6

Metastases from neuroblastoma
Metastases from nephroblastoma
Histiocytosis

Front 7

What is the most likely etiology at ages 15 to 40?

Back 7

Vascular tumor (e.g.,hemangioendothelioma)

Front 8

What are the three most likely etiologies at age >40?

Back 8

Metastases
Multiple myeloma
Lymphoma

Front 9

What two other multiple-lesion processes can affect patients at a variety of ages?

Back 9

Fibrous dysplasia
Paget’s disease

Front 10

What three tumors often demonstrate predominantly cortical involvement or tunneling?

Back 10

Ewing sarcoma (occasionally)
Osteomyelitis (cortical tunneling classically)
Osseotibrous dysplasia

Front 11

What are the five key differential diagnoses for a lytic lesion within the sacrum?

Back 11

Chordoma
Chondrosarcoma
Giant cell tumor
Metastasis
Myeloma

Front 12

What is the key differential diagnosis for a centrally located lytic lesion in
a pediatric humeral shaft without periosteal reaction?

Back 12

Unicameral bone cyst

Front 13

What are the three key differential diagnoses for a pagetoid-looking pelvis and unilateral femoral involvement?

Back 13

Polyostotic fibrous dysplasia
Ollier disease
Paget's disease

Front 14

A widened femoral metaphysis may suggest what disorder?

Back 14

Multiple hereditary exostoses (MHE)

Front 15

What six tumors classically involve the anterior vertebral body?

Back 15

Eosinophilic granuloma
Giant cell tumor
Osteosarcoma
Hemangioma
Metastases
Myeloma

Front 16

What three tumors classically involve the posterior spinal elements?

Back 16

Aneurysmal bone cyst (ABC)
Osteoid osteoma/blastoma
Osteochondroma

Front 17

What tumors classically involve the neuroforamina?

Back 17

Neurofibromatosis (NF)

Front 18

What are the Hve components of the differential diagnosis of an intramedullary destructive lesion of the hand or foot?

Back 18

Enchondrorna
Giant cell tumor (no bone on histology)
Giant cell reactive granuloma (bone present on histology)
Aneurysmal bone cyst (ABC)
Metastases

Front 19

What are punched-out lytic lesions?

Back 19

Lytic lesions that look as if they were created by a hole punch in bone

Front 20

Among younger patients, what lesion classically has this appearance?

Back 20

Eosinophilic granuloma

Front 21

What lesion classically has this appearance among older patients?

Back 21

Multiple myeloma