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52 Cards in this Set

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mnemonic for benign cystic bone lesions
FEGNOMASHIC
Fibrous dysplasia
Enchodroma, E Gran
Giant Cell Tumor
Non-Ossifying FIbroma
Osteoblastoma
Mets, MM
ABC
Solitary Bone cyst
Hyper PTH
Infx
Chondroblastoma, Chodromyxoid
distinguishing characteristic of fibrous dysplasia
no periosteal rxn
location of fibrous dysplasia
pelvis (will almost always include ipsilateral prox femur)
prox femur (does not have to include pelvis)
ribs
skull
jaw
appearance of fibrous dysplasia
"ground glass" = "buzzword"
can be patchy, sclerotic, lucent, single or mutliple.
(basically can look like anything)
mccune albright syndrome
cafe au lait spots
precocious puberty
polyostotic fibrous dysplasia
fibrous dysplasia appearance in ribs
anterior is sclerotic
posterior is expansile/lytic
adamantinoma
malig lesion that resembles FD, seen in tibia and jaw
characteristis of giant cell tumor
only in pts with closed epiphysis
lesion must abut the articular surface with no margin of nml bone
eccentrically located
sharply defined ZOT that is NOT sclerotic
who gets non-ossifying fibromas
<30 yo
location of NOF
metaphysis of long bones most often
emanates from cortex
where is NOF most common
knee
borders of NOF
often has thin, sclerotic border that are scalloped (although this is not always seen) and slightly expansile
T or F
NOF is a do not touch lesion
T
CT findings with regards to cortex of NOF
cortex can be interrupted without cortical destruction, but rather cortical displacement by benign fibrous tissue
periostitis in NOF
only if h/o trauma
pain in NOF
no
apperance of osteoblastoma
can be bubbly and look like osteoid osteoma or simulate ABC with soap-bubble, expansile appearance

a rare lesion; should mention anytime ABC is in the differential.
common location of osteoblastoma
posterior elements of vertebral bodies
DDX of expansile, lytic lesion sof posteiror elements of spine
osteoblastoma
ABC
TB
age descriminator to think of mets/MM
>40 yo
which bone mets are lytic?
lytic:
renal, thyroid
appearance of ABC
who gets it?
aneurysmal/expansile
<30 yo
presentation of ABC
pain
other names for solitary bone cyst
simple bone cyst
unicameral bone cyst
how to differentiate ABC from solitary bone cyst
ABC - painful, expansile, <30 yo

SBC - painless, central, often has fallen fragment sign (<30 yo too)
importance of sequestrum in osteomyelitis
what does sequestrum represent
if present = devitalized bone with no blood supply, ,requires surgical intervention
DDx sequestrum
osteo
E gran
lymphoma
fibrosarcoma
osteoid osteoma (mimics sequestrum)
location within bone for solitary bone cyst
always CENTRAL in location
most common location of SBC within body
prox femur or humerus
inferior calcaneous
presentation of SBC
asx, unles fx'd (which is common)
periostitis in SBC?
no
classic XR finding of SBC
fallen fragment sign
(= a portion of cortical bone has broken off and falls in dependent portion of hte lesion --> fluid-fluid cystic lesion)
THIS FINDING IS PATHOGNOMONIC FOR SBC!!!!!
growth pattern of SBC
starts growing at physeal plate in ong bones and then grows into shaft
what are brown tumors assoc with
hyper PTH
appearance of brown tumor
subperiosteal bone resorption
if physes are open, there is cupping/fraying
which bones are most affected by brown tumor
radial aspect of middle phylanges (and other phylanges)
distal clavicle,
medial aspect of prox tibia
SI joint s
where in bone does chondroblastoma occur
only in epiphysis
who gets chondroblastoma
<30 yo
DDx of young person with lytic lesion in epiphysis
Infx
Chondroblastoma
giant cell tumor
subchondral cyst
geode
dz associated with subchondral cysts
DJD
RA
CPPD/Pseudogout
AVN
apperance of a chondromyxoid fibroma
resembles NOF except often extends into epiphyssi
chondromyxoid fibroma - benign or malig?
cartilagenous lesion that can progress to malignancy rarely
presentation of chondromyxoid fibroma
presents with pain (unlike NOF)
difference between epiphysis and apophysis
epiphysis contributes to the length of bone
apophysis = ligament attachment sites
regardless of appearance of lytic lesion, what should be on every ddx if <30 yo
E gran
infx
regardless of appearance of lytic lesion, what should be on every ddx in >40 yo
infx
metx
MM
Lesions with no pain or periostitis
Fibrous dysplasia
Enchondroma
NOF
SBC
DDx for cystic rib lesion
Fibrous dysplasia
ABC
Mets
MM
Enchondroma
E gran
Epiphyseal lesions
Infx
Giant Cell
Chondroblastoma
Subchondral cyst
DDx for multiple cystic bone lesions
FEEMHI
Fibrous dysplasia
E Gran
Enchondroma
Mets, MM
HyperPTH
Infx
ollier disease
multiple enchondromas, no incresaed rate of malignancy
not hereditary
maffucci syndrome
multiple enchondromas and hemangiomas
not hereditary, has increased risk of malig