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37 Cards in this Set

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Lytic lesion with ossified matrix
Osteosarcoma
Osteoma
Osteoid osteoma
Osteoblastoma
Osteofibrous dysplasia
Amorphous mineralization in a lytic bone lesion
Infarct
Amyloid
Colloid ca met
Ground glass mineralization in a lytic bone lesion
Fibrous dysplasia
Lytic bone lesions with trabeculae
Thin-
GCT, ABC

Thick-
CMF, desmoplastic fibroma

Striated - hemangioma
Lytic bone lesions with elongated shape
Fibrous dysplasia
Lymphoma
Ewing
Angiosarcoma
Chondrosarcoma
Osteomyelitis
Brodie abscess
Lytic bone lesions in the epiphysis
Subchondr cyst /ganglion
Chondroblastoma
GCT
Infection
Clear cell chondrosarcoma
Paget's
EG
Mets
Subarticular osteoid osteoma
Lytic bone lesions with patient over 20yo
GCT, Hemangioma, Enchondroma,
Lipoma, Osteoma

Chondrosarcoma, Osteosarcoma, Plasmacytoma

Fibrous lesions (many)
Diffuse osteosclerosis
Metabolic-
hypERparathyr
hypOthyroid
hypER vitD
Fluorosis

Neoplastic
Mets
Lymphoma
Blastic myeloma (POEMS)
Osteosarc

Overgrowth w/o tumor
Mastocytosis
Paget's
Myelofibrosis
Sarcoid
TS
Osteopetrosis
Pyknodysostosis
Bone tumor has associated ST mass
Ewing
MFH / Fibrosarcoma
Chondrosarcoma
Met
MM
Osteosarcoma
Osteomalacia - what bony lesions predispose?
NOF/FCD
FD
Hemangiopericytoma
Blowout Mets in bone
Renal
Thyroid
Melanoma
MM
1° Lytic Lesions of the Spine
GCT
Osteoblastoma
ABC
Plasmacytoma
EG
Lucent Lesion with Pronounced Surrounding Sclerosis
Osteoid osteoma
Osteoblastoma
Brodie abscess
Stress Fx
Juxtaarticular Osteoporosis
RA / JRA
TB
Psoriatic arthritis
Synovial sarcoma
Bone lesion with Fluid-Fluid Levels
ABC
Telangiectatic osteosarcoma
Chondroblastoma
GCT
MFH
FD
Hemosiderin Deposition around joint
PVNS
Hemophilia
Chronic hemarthrosis
Synovial Hemangioma
Characteristics of Brodie Abscess
Subacute pyogenic osteo(staph)
Children, M>F
Metaphysis
Tibia, tarsal bones
Lytic lesion with dense sclerotic rim
Tubular, tortuous extending to physis
Periosteal rx, STS
MR: T2WI: high SI gran. tissue surrounded by low SI sclerosis
DDx: osteoid osteoma
Characteristics of osteoid osteoma
(kinds, imaging char, patients, ddx)
Cortical (70-80%): long bones, lucent, dense surr sclerosis
Cancellous (25%): intramedullary, fem. neck, post. elements, tubular bones, less sclerosis, can be subarticular
Subperiosteal (rare): juxtacort., ST mass eroding cortex, little sclerosis

Age 10-35 years, M:F = 2-3:1
Nocturnal pain

MR - lots of BM edema
Angio- dense blush

Ddx- DDx : Brodie abscess, stress fx, enostosis
Enchondroma
Lytic, <3cm centric metadiaph lesion w chondroid matrix

MRI: foci of signal void (Ca2+), ↑T2 , no sig. enhance

60% tubular bones, 25-45% long bones (malig. degen. in 15-20%), NOT skull (not formed by enchondral ossif.)

Age 15-40, M:F = 1:1
Pain without fracture  consider malignancy

DDx: bone infarct (serpentine border, more sclerotic, no endosteal scalloping), chondrosarc., juxtacortical chondroma, epidermoid inclusion cyst, UBC, FD
Glomus Tumor
Hamartoma - elements of neuromyoarterial apparatus

4th-5th decade
Soft tissues: tips of digits, subungual; rarely in bone

Pain :
--Love test: precise localiz of pain w/ pencil tip
--Hildreth test: pain resolves w proximal arm tourniquet

MRI: ↑T2 SI, enhancement

DDx: epidermoid inclusion cyst, enchondroma, chronic osteomyelitis, sarcoid, met, osteoid osteoma, subungual melanoma
Cortical Desmoid
Periosteal new bone + subperiosteal cortical defect along posteromedial & superior aspect MFC (medial ridge of linea aspera) at attachment of adductor magnus aponeurosis

“Pulling” lesion
“Leave me alone” lesion (Bx could resemble osteosarcoma)
Age 3-17 (pk 14-16), M:F=3:1
DDx: stress Fx, osteoid osteoma, NOF/fibroxanthoma
Myositis Ossificans
Benign ossifying ST mass
80% intramuscular

Hx of trauma in 75%
Adolescents, young adults; M>F

Hemorrhage, myonecrosis
“Zonal” sign, +/- periost Rx
Regresses in a few months

DDx: parosteal osteosarcoma, synovial sarcoma, osteochondroma, tumoral calcinosis, other sarcomas
Multiple lytic lesions
(FEEMHI):
fibrous dysplasia
enchondromas
EG
mets, myeloma
HPT
infection
Rib lesions
(FAME):
fibrous dysplasia
ABC
mets, myeloma
enchondroma, EG
Lytic epiphyseal lesion

(also apophyseal, carpal and tarsal bones, patella):
- Chondroblastoma, clear cell chondrosarc, CA (mets/myel)
- ABC (young patient)
- Geode (if DJD present)
- GCT (if epiphyses closed)
- Infection
- EG (if <30yo)


age>40 – add mets and myeloma and remove chondroblastoma
Lytic lesion in posterior elements of spine
(OAT): osteoblastoma, ABC, TB
Exclude these lytic lesions if age>30
(CANES):
chondroblastoma
ABC
NOF
EG
SBC
Lesions that have no pain or periostitis
(FENS):
fibrous dysplasia
enchondroma
NOF
SBC
Bony sequestrum
(FILE):
fibrosarcoma
infection
lymphoma
EG
osteoid osteoma (mimic)
Geodes
(CARD):
CPPD
AVN
RA
DJD

trauma
Sclerotic lesion age 20-40:
chondroblastoma, ABC, NOF, EG, SBC, FD, infection, HPT (healing brown tumor), osteoid osteoma, giant bone island

age>40 - mets
Endosteal scalloping:
fibrous dysplasia
enchondroma
cartilaginous tumor
Wide zone of transition (permeative):
mets + myeloma
reticulum cell sarcoma
Ewing’s

infection
EG
Malignant transformation of bony lesions:
FD – fibrosarcoma, OSA, MFH
Paget’s – OSA
osteo w draining sinus – SCC
RTX– OSA, chondrosarcoma, MFH
bone infarct– fibrosarc, MFH
Ollier’s – chondrosarcoma
Maffucci’s – chondrosarcoma
osteochondroma- chondrosarc
Mets to bone
PBKTL
P – mostly blastic
B – mixed,
K – purely lytic
TL – mostly lytic
Lytic lesion in ilium
FD, ABC, SBC

hemophilia

mets, plasmacytoma, Ewing’s,
chondrosarcoma, lymphoma
Lytic sacrum lesion
met

chordoma (sacrum, clivus, vertebrae, expansile lytic lesion w large ST component and variable Ca++)

plasmacytoma

chondrosarcoma

GCT