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24 Cards in this Set
- Front
- Back
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How to see gross anatomy of a bone
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radiographs are best.
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Certain areas of the bone...
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predispose to certain kinds of tumors
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if tumor is slow growing....
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normal bone has time to respond physiologically and will increase volume around the lesion so it appears white on plain xray.
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if tumor is fast...
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permeated pattern on xray because normal bone can't respond fast enough.
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Malignancies like leukemia...
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may not show any change on xray. but malignancies can present very variably.
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acute inflammation (osteomyelitis)...
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can resemble malignancy but clinical picture will suggest infection and not malignancy
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If lesion mineralizes...
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it came from cartilage or bone.
and cartilage lesions are only where there normally is cartilage (i.e. won't see it in certain parts of the face that have intramembranous ossification) |
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Osteosarcoma makes...
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MALIGNANCY MINERALIZED BONE (doesn't necc go along with stress lines - the bone is oriented in a lacy way)
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Cartilage lesions
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often show rings and arcs bc that is how cartilage grows and then it is calcified around edges (endochondral ossification)
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ground glass/stippled...
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suggests fibrous dysplasia
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Ivory/solid pattern of calicifcaiton
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suggests malignant tumor causing more density of minrealized bone in the medulla.
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2 kinds of periosteal reactions
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codman's angle - looks like the periosteum has been lifted off. due to a lesion that grows btwn mineralizing periosteum and preexisting cortex. very typical of some malignancies or infections.
spiculated - bone growing perpendicular to long axis bc tumor is growing so fast the normal bone thinks that is the direction of force. very fast growth here. |
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slow growing-
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benign
geographic margins (clear where the lesion is) and solid periosteal rxn |
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intermediate growing -
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benign or malig
ill-defined or moth-eaten internal margins. shells is the periosteal reaction. |
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fast growing -
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malig
permeative internal margins and lamellar periosteal reactions |
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fastest growing -
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malig
invisible internal margins and spiculated/invisible periosteal rxn. |
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first pge of notes
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imp to know i think - table 1
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issue with trauma and bone lesions
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that is just what the pt remembers. often times, there is something (e.g. malignancy) that predisposed their trauma to actually result in a fracture
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enchondroma
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lytic lesion. geographical margin.
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osteosarcoma
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whole length will be abnormal. not geographic.
doesn't follow wolf's law. quick death. |
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staphylococcus osteomyelitis
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entire humerus in this case.
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sign of dead bone
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can't see osteocytes.
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coccidioidomycosis osteomyelitis
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granulomatous.
permeative destruction |
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metastatic carcinoma of bone
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can induce bone formation via cytokine response
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