Pathology (bone conditions) - Irene Gold Booklet :)

Fallen Fragments sign indicates

Unicameral bone cyst/simple bone cyst

Unicameral/simple bone cysts affect

Central- Diaphysis/metaphysis of long bones in people under 20

Aneurysmal bone cysts affect

Eccentric- diaphysis/metaphysis in people under 20

"Blister on bone" or "finger in balloon" appearance indicates

Aneurysmal bone cyst

Simple bone cysts will __________ bone expansion; aneurysmal bone cysts will _______ bone expansion

Not have; have

Soap bubble appearance on a knee x-ray indicates

Giant Cell Tumor (osteoclastoma)

What is the most common benign bone tumor of the hand

Enchondroma

What is Ollier's disease

Multiple enchondromas

What is Maffucci's syndrome

Multiple enchondromas and soft tissue calcification

What Xray sign is associated with enchondroma

Stippled appearance (tiny white dots)

What is the most common benign bone tumor of the spine

Hemangioma

What Xray sign indicates hemangioma

Corduroy cloth or jail bar appearance

Monostotic fibrous dysplasia is found where

Proximal femur (rind sign)

What type of fibrous dysplasia is more common

Monostotic

Pt presents with Cafe au lait spots (Coast of Maine) and "ground glass" appearance on Xray

Fibrous dysplasia

What is Albrights disease

Early puberty + fibrous dysplasia

Pt presents with Cafe au lait spots (Coast of California) and vertebral body scalloping is seen in

Neurofibromatosis/ Von Recklinghausens disease

What is the most common benign bone tumor of the neural arch

Osteoblastoma

What is the most common benign bone tumor of the appendicular skeleton

Osteochondroma

Coat hanger exostosis, cartilagimnous cap, cauliflower-like describes what tumor

Pedunculated osteochondroma

What is the appearance of sessile osteochondroma

Broad-based exostosis

Pt presents with night pain that is relieved by Aspirin, Xray shows radiolucent central nidus and severe reactive sclerosis

Osteoid osteoma

What is the most common benign bone tumor of the skull

Osteoma

Where are osetoma's commonly found

Frontal sinus

What is the most common primary malignancy of bone

Multiple myeloma/ plasma cell sarcoma

Punched out lesions/ raindrop skull is associated with what

Multiple myeloma (malignant bone tumor)

What lab findings are associated with multiple myeloma

M spike (immunoelectrophoresis), inverted/reversed albumin/globulin ratio, bence jones proteinuria, Russell inclusion bodies

Winking owl sign and swiss cheese skull are name signs associated with

Lytic metastasis

Ivory white vertebra, snowball appearance are name signs associated with

Blastic metastasis

What lab finding is seen in lytic and blastic metastasis

Increased alkaline phosphatase

Most common form of metastasis in people 20-30

Hodgkins Disease

Pt presents with Pel-epstein fever, hepatosplenomegaly and enlarged lymph nodes. Anterior VB scalloping is seen on Xray

Hodgkins disease

What special test is used to diagnose Hodgkins disease

Biopsy for Reed Sternberg cells

What are the stages of Pagets/osteitis deformans

1) lytic/destructive 2) combined 3) blastic 4) malignant (osteosarcoma)

Shepards crook femur, sabre shin tibia, brim pelvis, picture frame vertebra are name signs associated with

Pagets / osteitis deformans

What lab findings are seen in Pagets disease

Increased alkaline phosphatase and urinary hydroxyproline

A sunburst/spiculated periosteal reaction in a 15 year old you should be concerned of

Osteosarcoma

Onion skin (laminated) periosteal reaction, Codmans triangle affecting the diaphysis of long bones in an 15 year old may indicate

Ewings Sarcoma

Where are chordoma's mostly found

Sacrum or clivus of occiput

RA + dry eyes + dry mouth is what condition

Sjogrens disease

PT presents with Hagarths nodes, lanois deformity and rat bite erosions

Rheumatoid arthritis

Rheumatoid arthritis in children can be called

Still's disease

40 yo female Pt presents with acro-osteolysis, and +FANA,

Scleroderma/ progressive systemic sclerosis

What is CREST syndrome

Calcinosis, Raynaud's, esophageal dysfunction, Sclerodactyly, Telangiectasia

Libman-Sacks endocarditis is associated with what seropositive arthritide

Systemic lupus erythematosus

30 yo female presents with malar rash on face, light sensitivity and +ANA test

Lupus

On Xray you see mouse ear deformity, ray sign and non-marginal syndesmophytes

Psoriatic arthritis

What non-bone findings may a patient with psoriatic arthritis present with

Silver scaly lesions on extensors, pitted nails, sausage (swollen) digits

16 yo male presents with low back pain/stiffness and iritis. You do an Xray and see bilateral SI jt fusion, what condition?

Ankylosing spondylitis

What condition is radiographically the same as Marie strumpell disease but also has GI dysfunction

Enteropathic arthritis

Reactive arthritis is most commonly caused by

Chlamydia

What is the classic triad of reactive arthritis

Urethritis, conjunctivitis, arthritis

Patients who are stiff with more rest and improve with activity describes

Osteoarthritis/ DJD

Heberdens nodes occur at the _______ joint in _________

DIP; osteoarthritis

Bouchards nodes occur at the _______ joint in ________

PIP; osteoarthritis

Haygarths nodes occur at the _________ joint in __________

MCP; rheumatoid arthritis

40 yo diabetic male presents with neck stiffness and dysphagia what condition do you suspect

diffuse idiopathic hyperostosis

How many segments must be involved to diagnose DISH

4 continuous segments (flowing hyperostosis)

What is affected in Forestiers disease

Calcification of ALL (possible PLL)

What are the 6D's that are associated with Charcot's Joint?

1. Density

2. Debris

3. Destruction

4. Dislocation

5. Distention

6. Disorganization

Impaired sensation to a joint like in diabetes mellitus or syphillis can lead to what joint condition

Neurogenic arthropathy

Neurogenic arthropathy is also known as

Charcot's joint

What causes Gout

Overproduction of uric acid from increased purines in diet (red meat, red wine, beer)

What is the most common site of gout

MTP of big toe

Xray shows tophi crystals, overhanging margin sign, and juxta articular erosions indicate

Gout

What special test can be used to diagnose gout

Joint aspiration

The most common cause of avascular necrosis is _______ and second is _________

Trauma; corticosteroids

AVN in the scaphoid is called

Preisers

AVN of the navicular is called

Kohler's disease

AVN of lunate is called

Keinbochs

AVN of the calcaneus is called

Severs

AVN of VB endplate

Scheurmanns

Who is most at risk for Scheurmanns disease

Male Patients 10-16

Crescent sign, snowcap sign in a 5 year old boy indicates

Legg calve perthes

AVN of the femoral epiphysis is called

Legg calve perthes

What is Brodie's abscess?

Chronic osteomyelitis (bone infection)

What is the process of osteomyelitis

Sequestrum (necrotic center), involucrum (new bone), cloaca (opening from bone to skin)

What is a colles fracture

distal radius fracture with dorsal displacement

What is a smiths fracture

fracture of the distal radius with anterior displacement

The Cho-pat brace is good to help with

Osgood schlatters

What are beaus lines

Transverse depressions in the nails indicating illness

What is the most common cause of paronychia

Herpes

What is paronychia

Inflammation of nail bed

What does a splinter hemorrhage indicate

Subacute bacterial endocarditis

What does spoon nails indicate

iron deficiency anemia