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49 Cards in this Set

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where does osteosarcoma occur within bone
site of rapid bone growth
where does Ewing sarcoma occur within bone
follows red marrow distributlion
examples of epiphyseal equivalents
greater troch
tibial tubercle
patella
carpals
tarsals
glenoid
SI joint
what are features of the borders of a lesion that are non-aggressive
sharp margins
narrow ZOT
(esp if borders are sclerotic)
types of periosteal rxn
unilamellated (slow-growing)
multilamellated
spiculated/hair on end
codman triangle (highly aggressive)
codman's triangle
classic assoc
elevation of periosteum from cortex, forming na angle
classically assoc with osteosarcoma, but really can be assoc with any aggressive process
if a lucency is seen in a bone and is 2/2 malig, explain pathophys
if there is a sclerotic lesion, then from
osteoclast activity
osteoblast activity
appearance of a chondroid matrix
varies, can be stippled, flocculent, or have rings and arcs
appearance of a bone forming matrix
can be fluffy, amorphous, or have cloudlike mineralization
size criteria for NOF and FCD
>3 cm, NOF
FCD <3cm
when does the risk of an enchondroma increase to actually being a chondrosarc
if >4-5cm
benign lesions that can have a soap bubble appearance
ABC
NOF
CMF
brown tumor
hemophiliac pseudotumor
malignant lesions that can have soap bubble appearance
mets
plasmacytoma
telangiectatic osteosarcoma
location of chondromyxoid fibroma
rare metaphyseal lesion that can extend to epiphysis
what is multiple hereditary exostosis assoc with
increased risk of chondrosarcoma
MR appearance of multiple hereditary exostosis
int T1, int/high T2
is bone marrow edema assoc with giant cell tumor
not unless fx'd
location within bone of osteosarcoma
usually metaphyseal
location within bone of Ewing sarcoma
usually diaphyseal
age of pts who get osteosarcoma
<30 yo
secondary osteosarcoma in paget's disease or 2/2 radiation
how does parosteal osteosarcoma differ from regular osteosarcoma
parosteal osteosarc: originates from periosteum and grows outside bone, less aggressive as long as it doesn't invade medullary cavity
conventional osteosarcoma: agressive growth within medullary cavity --> cortical and soft tissue penetration
appearance of conventional osteosarcoma
often heavily ossified, with dense sclerotic areas, but can have chondroid or lucent matrix
what lesions mimic parosteal osteosarcoma
cortical desmoid tumor (avulsion injury that is benign but an appear aggressive)
myositis ossificans
describe cortical desmoid tumor
common location
posteromedial supracondylar ridge of distal femur, 2/2 avulsion of adductor magnus muscle
+/- activity on bone scan
+/- periosteal rxn
DO NOT TOUCH LESION!!!
where does ewing sarcoma usually occur
diaphysis of long bone (but less often can also be in diametaphyseal and metaphyseal regions and in flat bones)
appearance of ewing sarcoma
usually permeative but can have partially sclerotic or patchy appearance
classic ddx of permative lesion in a child
ewing
infx
eg
who gets chondrosarc
adults >40, rare in children
on mr, what features may help lead to a dx of chondrosarc
soft tissue mass ro edema in a lesion that looks like enchondroma
where do giant cell tumors most commonly metastasize
lungs
which malig bone tumor can have a sequestrum
fibrosarcoma
malig fibrous histiocytoma
desmoid tumor
how to differentitate btwn fibrosarc and malig fibrous histiocytoma
can be identical to fibrosarc
which is more common fibrosarc or malig fibrous histiocytoma
MFH
other names for desmoid tumor
desmoplastic fibroma
aggressive fibromatosis
where is desmoid tumor most common
in soft tissues
appearance of desmoid tumor
lytic when in bone (which rarely occurs)
well defined, have benign periostitis with thick spikes
may have bony septa
another name for primary lymphoma of bone
reticulum cell sarcoma
what does primary lymphoma of bone resemble
appearance
how to differentiate
ewing sarcoma (permeative, moth eaten)
presentation of primary lymphoma of bone
pts are usually asx despite having lrg amt of bone involved
plasmacytoma
lytic bone lesion
2 most common soft tissue tumors
MFH
liposarcoma
t or f:
liposarc must contain fat radiographically
false
where in body do synovial sarcomas originate
adjacent to joints most commonly
appearance of synovial sarcoma on MR
homogeneously bright on T2 (may be mistaken for fluid clxn)
give gad, to see if it enhances
XR appearance of synovial osteochondromatosis
multiple calcific loose bodies in joint (pathognomonic)
what can synovial osteochondromatosis be confused with sometimes and why
PVNS (pigmented villnodular synovitis) b/c in up to 20% of time, teh loose bodies in osteochondromatosis are not calcified
is synovial osteochondromatosis benign or malig
benign (a do not touch lesion)
appearance of pvns on MR and XR
marked low signal lining of synovium on T1 and T2 b/c of hemosiderin deposits
lrg erosions
ddx pvns
osteochondromatosis
hemosiderotic arthritis (rare, from chronic bleeding into a joint)