Msk Review 1

Front 1

MR characteristics of chondroblastoma

Back 1

lobulated cartilage appearance with substantial edema
only cartilage lesion that is low/intermediate T2
extensive surrounding edema
+/- joint efusion
+/- periosteal rxn

Front 2

lesion that simulates a chondroblastoma but is seen in older pts
typical location and appearance of this lesion

Back 2

clear cell chondrosarcoma
epiphysis
different from chondroblastoma b/c is bright on t2

Front 3

imaging characteristics that to distinguish giant cell tumor from chondroblastoma

Back 3

gct rare in teenagers (need closed epiphysis)
no bone marrow edema or periosteal rxn
low T2

Front 4

management of gct

Back 4

curettage and methylmetacrylate

Front 5

t or f: giant cell tumors can metastasize

Back 5

true!

Front 6

early appearance of primary bone leukemia

Back 6

focal nodular replacement of bone marrow
intense enhnaceemnt
no loss of signal on out of phase imaging

Front 7

appearance of a morton neuroma

Back 7

between metatarsal heads and neck
dumbbell shaped mass with intermediate to low t1 and t2
will see replacement of nml fat on T1 short axis
+enhancement

Front 8

what is dx if you are in 2nd interspace and there are both high and low signal within a dumbbell shaped lesion on T2

Back 8

morton's neuroma + bursitis

Front 9

what is a morton's neuroma

Back 9

fibrosing process from compression of the plantar digital nerve

Front 10

how to differentiate between hibernoma and lipoma

Back 10

hibernomas don't exhibit rapid growth
hibernoma: dirty fat, high on T2, t1 variable, but usually darker than subQ fat
low signal septations are common

Front 11

appearance of chordoma

Back 11

usually in sacrum
locally destructive, lytic lesion
can get very large
high on t2, low /iso t1
may have calcs peripherally

Front 12

typical appearance of telangiectatic osteosarcoma

Back 12

lytic and expansile
fluid levels common
areas of cortical disruption
can be misdx as an abc

Front 13

when should the possiblity of angiosarcoma be suggested

Back 13

multiple lytic lesions clustered in a single anatomic region

Front 14

thing to suggest benign vs malignant osteochondroma

Back 14

look at the cartilage cap, if greater than 2cm, suggests malig (although not a hard and fast rule, esp in a pt who is growing)

Front 15

at what age does malig transformation of osteochondroma usually occur

Back 15

25-30 yo

Front 16

loc of enchondroma

Back 16

central, often metaphyseal

Front 17

appearance of enchondroma in short tubular bones

Back 17

expansile remodeling with prominent thinned cortex (in short tubular bones)

Front 18

why do enchondromas have a lobulated appearance on mr

Back 18

all hyaline cartilage lesions grow in lobules.
bones get scalloped, but unevenly

Front 19

why is there ring and arc appearance on xr in bone infarcts

Back 19

it's artifactual (just due to serpiginus margins of bone infarct seen en face)
there is no true ring and arc mineralization in bone infarct

Front 20

aids to differentiate enchondroma vs chondrosarcoma

Back 20

enchondroma: rare in axial ske, common in hand/foot, common in long bones, painless, endosteal scalloping <2/3 cortex, no cortical thickening or periosteal rxn;

chondrosarc:common in axial skeleton, long bones, rare in hand/foot; pain, endosteal scalloping depth >2/3 cortex, +/- cortical thickening and periosteal rxn, enhancement

change over time would favor chondrosarc

Front 21

most frequently seen aggressive lytic primary tumors in 30-60 yo

Back 21

fibrosarcoma
mfh
histioctyoma of bone
primary lymphoma of bone

Front 22

appearance of sarcoid in teh bone

Back 22

lace-like lytic lesions in the hands and feet

Front 23

mr appearance of sarcoid of the bone

Back 23

low t1, high t2
+enhancement
most common in the metaphyses

Front 24

osseous abnormalities assoc with ts

Back 24

hyperostosis of inner table +sclerotic foci
hypertrophic osteoarthropathy in hands and feet

Front 25

what is the most common phalangeal tumor

Back 25

enchondroma

Front 26

what lesion to think of when you see columns of cartilage extending into metaphysis from epiphyseal plate

Back 26

enchondroma (or other cartilagenous lesion)

Front 27

t or f: cupping can be seen in the physis adjacent to enchondromas in ollier's disease

Back 27

true

Front 28

t or f: ollier's disease is most often b/l

Back 28

false, usually unilateral

Front 29

complications of ollier disease

Back 29

chondrosarcoma

Front 30

mode of inheritance in ollier disease

Back 30

not hereditary

Front 31

complications/other diseases assoc with maffucci syndrome

Back 31

chondrosarc
vascular sarcoma
ovarian, pancreatic malign
gliom/carcinoid

Front 32

findings of metaphyseal dysplasia

Back 32

flaring of the ends of long bones with constriction and sclerosis of diaphysis
mild cranial sclerosis
can cause erlenmeyer flask deformity

Front 33

another name for metaphyseal dysplasia

Back 33

pyle's disease

Front 34

which type of chondrosarcoma can have a rim of sclerosis

Back 34

clear cell chondrosarcoma, similuate a non-aggressive lesion

Front 35

how to differentiate chondroblastoma from clear cell chondrosarcoma

Back 35

both are epiphyseal lesions
older age in clear cell chondrosarc
no surrounding BM edema (which there is a lot of in chondroblastoma)

Front 36

imaging features of an atypical llipomatous tumor

Back 36

thickend enhancing septum and nodules

Front 37

what is atypical lipomatous tumor indistinguishable from

Back 37

well defferentiated liposarcoma