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Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often around the distal femur, proximal tibial region.

Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells

Benign
Giant Cell Tumor
Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often around the distal femur, proximal tibial region.

Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells

Benign
Occurs most commonly at epiphyseal end of long bones.
Giant Cell Tumor
Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often araound the distal femur, proximal tibial region.

Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells

Benign
Peak incidence 20-40 years old.
Giant Cell Tumor
Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often araound the distal femur, proximal tibial region.

Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells

Benign
Locally aggressive benign tumor often around the distal femur, proximal tibial region.
Giant Cell Tumor
Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often araound the distal femur, proximal tibial region.

Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells

Benign
Characteristic "double bubble" or "soap bubble" appearance on x-ray.
Giant Cell Tumor
Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often araound the distal femur, proximal tibial region.

Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells

Benign
Spindle-shaped cells with multinucleated giant cells
Giant Cell Tumor
Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often araound the distal femur, proximal tibial region.

Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells

Benign
3 Benign primary bone tumors
Giant Cell Tumor

Osteochondroma (exostosis)

Enchondroma
Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often araound the distal femur, proximal tibial region.

Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells

Benign
Giant Cell Tumor - occurs where?
Occurs most commonly at epiphyseal end of long bones.

Locally aggressive benign tumor often around the distal femur, proximal tibial region.
Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often araound the distal femur, proximal tibial region.

Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells

Benign
Giant Cell Tumor - peak incidence
Peak incidence 20-40 years old.
Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often araound the distal femur, proximal tibial region.

Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells

Benign
Giant Cell Tumor - appearance on x-ray and histology
Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells
Occurs most commonly at epiphyseal end of long bones. Peak incidence 20-40 years old. Locally aggressive benign tumor often araound the distal femur, proximal tibial region.

Characteristic "double bubble" or "soap bubble" appearance on x-ray.

Spindle-shaped cells with multinucleated giant cells

Benign
Most common benign tumor

Usually in men <25 years

Commonly originates from long metaphysis

Malignant transformation to chondrosarcoma is rare.
Osteochondroma (exostosis)
Most common benign tumor

Usually in men <25 years

Commonly originates from long metaphysis

Malignant transformation to chondrosarcoma is rare.
Most common benign tumor
Osteochondroma (exostosis)
Most common benign tumor

Usually in men <25 years

Commonly originates from long metaphysis

Malignant transformation to chondrosarcoma is rare.
Usually in men <25 years
Osteochondroma (exostosis)
Most common benign tumor

Usually in men <25 years

Commonly originates from long metaphysis

Malignant transformation to chondrosarcoma is rare.
Commonly found metaphysis of long bones
Osteochondroma (exostosis)

and

Osteosarcoma (osteogenic carcinoma)
Most common benign tumor

Usually in men <25 years

Commonly originates from long metaphysis

Malignant transformation to chondrosarcoma is rare.
can rarely transform to malignant chondrosarcoma
Osteochondroma (exostosis)
Most common benign tumor

Usually in men <25 years

Commonly originates from long metaphysis

Malignant transformation to chondrosarcoma is rare.
Osteochondroma is found in which age groups and gender?
men < 25 y.o.
Most common benign tumor

Usually in men <25 years

Commonly originates from long metaphysis

Malignant transformation to chondrosarcoma is rare.
Osteochondroma can rarely transform into...
chondrosarcoma
Most common benign tumor

Usually in men <25 years

Commonly originates from long metaphysis

Malignant transformation to chondrosarcoma is rare.
Osteochondroma often arises where?
long metaphysis
Most common benign tumor

Usually in men <25 years

Commonly originates from long metaphysis

Malignant transformation to chondrosarcoma is rare.
Benign cartilaginous neoplasm found in intramedullary bone.

Usually distal extremities (vs. chondrosarcoma
Enchondroma
Benign cartilaginous neoplasm found in intramedullary bone.
Enchondromas are
Benign cartilaginous neoplasm found in intramedullary bone.
Benign cartilaginous neoplasm found in intramedullary bone.
Enchondromas are often found where?
Benign cartilaginous neoplasm found in intramedullary bone.

Usually distal extremities
Benign cartilaginous neoplasm found in intramedullary bone.
Name 3 malignant primary bone tumors
Osteosarcoma (osteogenic carcinoma)

Ewing's sarcoma

Chondrosarcoma
Most common primary malignant tumor of bone.

Peak incidence in men 10-20 years old.

Commonly found in the metaphysis of long bones.

Predisposing factors include Paget's disease of bone, bone infarcts, radiation and familial retinoblastoma.

Codman's triangle (from elevation of periosteum) on x-ray
Osteosarcoma (osteogenic carcinoma)
Most common primary malignant tumor of bone.

Peak incidence in men 10-20 years old.

Commonly found in the metaphysis of long bones.

Predisposing factors include Paget's disease of bone, bone infarcts, radiation and familial retinoblastoma.

Codman's triangle (from elevation of periosteum) on x-ray
Most common primary malignant tumor of bone.
Osteosarcoma (osteogenic carcinoma)
Most common primary malignant tumor of bone.

Peak incidence in men 10-20 years old.

Commonly found in the metaphysis of long bones.

Predisposing factors include Paget's disease of bone, bone infarcts, radiation and familial retinoblastoma.

Codman's triangle (from elevation of periosteum) on x-ray
Peak incidence in men 10-20 years old.
Osteosarcoma (osteogenic carcinoma)
Most common primary malignant tumor of bone.

Peak incidence in men 10-20 years old.

Commonly found in the metaphysis of long bones.

Predisposing factors include Paget's disease of bone, bone infarcts, radiation and familial retinoblastoma.

Codman's triangle (from elevation of periosteum) on x-ray
Commonly found in the metaphysis of long bones.
Osteosarcoma (osteogenic carcinoma)

&

Osteochondroma (exostosis)
Most common primary malignant tumor of bone.

Peak incidence in men 10-20 years old.

Commonly found in the metaphysis of long bones.

Predisposing factors include Paget's disease of bone, bone infarcts, radiation and familial retinoblastoma.

Codman's triangle (from elevation of periosteum) on x-ray
Predisposing factors include Paget's disease of bone, bone infarcts, radiation and familial retinoblastoma.
Osteosarcoma (osteogenic carcinoma)
Most common primary malignant tumor of bone.

Peak incidence in men 10-20 years old.

Commonly found in the metaphysis of long bones.

Predisposing factors include Paget's disease of bone, bone infarcts, radiation and familial retinoblastoma.

Codman's triangle (from elevation of periosteum) on x-ray
Codman's triangle (from elevation of periosteum) on x-ray
Osteosarcoma (osteogenic carcinoma)
Most common primary malignant tumor of bone.

Peak incidence in men 10-20 years old.

Commonly found in the metaphysis of long bones.

Predisposing factors include Paget's disease of bone, bone infarcts, radiation and familial retinoblastoma.

Codman's triangle (from elevation of periosteum) on x-ray
Demographics of Osteosarcoma (osteogenic carcinoma)
Peak incidence in men 10-20 years old.
Predisposing factors for Osteosarcoma (osteogenic carcinoma)
Paget's disease of bone

bone infarcts

radiation

familial retinoblastoma
what does osteosarcoma look like on x-ray?
Codman's triangle from elevation of periosteum) on x-ray
Anaplastic small blue cell malignant tumor.

Most common in boys <15

Extrememly aggressive with early mets, but responsive to chemotherapy

Characteristic "onion-skin" appearance in bone ("going out for Ewings and onion rings")

Commonly appears in diaphysis of long bones, pelvis, scapula, and ribs.

11;22 translocation
Ewing's sarcoma
Where does Ewing's commonly appear?
Commonly appears in diaphysis of long bones, pelvis, scapula, and ribs.
translocation in Ewings
11;22 translocation
Malignant carilaginous tumor

Most common in men aged 30-60

Usually located in pelvis, spine, scapula, humerus, tibia, or femur

May be primary origin or from osteochondroma
chondrosarcoma
Malignant carilaginous tumor

Most common in men aged 30-60

Usually located in pelvis, spine, scapula, humerus, tibia, or femur

May be primary origin or from osteochondroma
Malignant cartilaginous tumor
chondrosarcoma
Malignant carilaginous tumor

Most common in men aged 30-60

Usually located in pelvis, spine, scapula, humerus, tibia, or femur

May be primary origin or from osteochondroma
Most common in men aged 30-60
chondrosarcoma
Malignant carilaginous tumor

Most common in men aged 30-60

Usually located in pelvis, spine, scapula, humerus, tibia, or femur

May be primary origin or from osteochondroma
Usually located in pelvis, spine, scapula, humerus, tibia, or femur
chondrosarcoma
Malignant carilaginous tumor

Most common in men aged 30-60

Usually located in pelvis, spine, scapula, humerus, tibia, or femur

May be primary origin or from osteochondroma
May be primary origin or from osteochondroma
chondrosarcoma
Malignant carilaginous tumor

Most common in men aged 30-60

Usually located in pelvis, spine, scapula, humerus, tibia, or femur

May be primary origin or from osteochondroma
Order of

Diaphysis, Epiphysis, and Metaphysis from ends to middle of bone
(end) Epiphysis

Metaphysis

(middle) Diaphysis