L5 - Benign Bone Tumors

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72 Terms

1
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Lateral proximal tibia

Bone

<p>Bone</p>
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- Longitudinal: epiphysis/metaphysis (up to joint surface)

- Eccentricity: eccentric

- Transverse: medullary

Location

<p>Location</p>
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Monostotic

Mono/polyostotic

<p>Mono/polyostotic</p>
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>1 cm

Size

<p>Size</p>
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- Lytic

- Geographic

- Short zone of transition

Behavior

<p>Behavior</p>
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- Cortical thinning

- Cortical expansion

Cortex

<p>Cortex</p>
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Nothing visible

Matrix

<p>Matrix</p>
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None

Periosteal reaction

<p>Periosteal reaction</p>
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Soft tissue swelling

Soft tissue involvement

<p>Soft tissue involvement</p>
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Joint surface involved

Joint involvement

<p>Joint involvement</p>
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Giant cell tumor

Most likely diagnosis?

<p>Most likely diagnosis?</p>
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Refer to orthopedist or oncologist

Next step?

<p>Next step?</p>
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Could be aggressive (20%)

Concerns/complications?

<p>Concerns/complications?</p>
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- Distal femur involved

- Elongated stalk

- Cortex and medulla are continuous

- Pointing away from joint

- Narrow base

Describe the bone lesion

<p>Describe the bone lesion</p>
15
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Pedunculated solitary osteochondroma

Most likely diagnosis?

<p>Most likely diagnosis?</p>
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Refer to orthopedist

Next step?

<p>Next step?</p>
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- Fracture

- Malignant transformation (chondrosarcoma)

- Bursitis

- Neurologic injury

Concerns/complications?

<p>Concerns/complications?</p>
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- Distal femur

- Metaphysis

- Anterolateral

- Broad base

- Cortex and medulla continuous

Describe the bone lesion

<p>Describe the bone lesion</p>
19
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Sessile solitary osteochondroma

Most likely diagnosis?

<p>Most likely diagnosis?</p>
20
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Hereditary multiple exostoses

Most likely diagnosis?

<p>Most likely diagnosis?</p>
21
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Malignant transformation (5-25%)

Concerns/complications?

<p>Concerns/complications?</p>
22
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Inherited metaphyseal overgrowth

How do you get this?

<p>How do you get this?</p>
23
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- Superior aspect of sacrum on right side

- Lucent/opaque brush-border oval

Describe the lesion

<p>Describe the lesion</p>
24
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Bone island

Most likely diagnosis?

<p>Most likely diagnosis?</p>
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Nothing

Next step?

<p>Next step?</p>
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Osteochondroma

Concerns/complications?

<p>Concerns/complications?</p>
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- Ulna

- Diaphysis

- Sclerotic

- Small, lucent nidus (< 1cm) in the cortex

- Geographic)

- Cortical thickening

Describe the lesion

<p>Describe the lesion</p>
28
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Osteoid osteoma

Most likely diagnosis?

<p>Most likely diagnosis?</p>
29
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Severe pain (worse at night, relieved by aspirin)

What is the hallmark history of a patient with this lesion?

<p>What is the hallmark history of a patient with this lesion?</p>
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- Refer to orthopedist

- Adjust spine

Next step?

<p>Next step?</p>
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None

Concerns/complications?

<p>Concerns/complications?</p>
32
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Paranasal sinus

What is the location of the lesion?

<p>What is the location of the lesion?</p>
33
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Osteoma

Most likely diagnosis?

<p>Most likely diagnosis?</p>
34
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Headaches

Concerns/complications?

<p>Concerns/complications?</p>
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Refer to EENT

What is your next step?

<p>What is your next step?</p>
36
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L1

What vertebral level is involved?

<p>What vertebral level is involved?</p>
37
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- Solitary vascular neoplasm

- Slow-growing

- Vertical striations (corduroy cloth)

- Fatty lesion

Describe the bone lesion

<p>Describe the bone lesion</p>
38
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Vertebral hemangioma

Most likely diagnosis?

<p>Most likely diagnosis?</p>
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- None with this patient

- Expansion (rare) may result in neurologic findings

Concerns/complications?

<p>Concerns/complications?</p>
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Lumbar

What spinal anatomy is involved?

<p>What spinal anatomy is involved?</p>
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- Fat body

- Mammillary process

- Posteromedial facets

Are there any distinguishing features?

<p>Are there any distinguishing features?</p>
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Vertebral hemangioma

Most likely diagnosis?

<p>Most likely diagnosis?</p>
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Adjust

Next step?

<p>Next step?</p>
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- Head of 5th metacarpal

• Cortical thinning

• Lucency in head

• Pathologic fracture

• Stippled calcification

• Cartilaginous matrix

• Geographic

• Short zone of transition

Describe the lesion

<p>Describe the lesion</p>
45
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Solitary enchondroma

Most likely diagnosis?

<p>Most likely diagnosis?</p>
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Fracture

What complication has occurred?

<p>What complication has occurred?</p>
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Refer to orthopedist

Next step?

<p>Next step?</p>
48
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Multiple enchondromas (Ollier's disease)

Diagnosis?

<p>Diagnosis?</p>
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- Malignant transformation (10-50%)

- Fracture

Concerns/complications?

<p>Concerns/complications?</p>
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- Flocculent calcification

- Metaphysis/diaphysis

- Enchondroma

- Cartilaginous matrix

Describe the lesion

<p>Describe the lesion</p>
51
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Enchondroma

Most likely diagnosis?

<p>Most likely diagnosis?</p>
52
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Malignant transformation (rare)

Concerns/complications?

<p>Concerns/complications?</p>
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Refer to orthopedist

Next step?

<p>Next step?</p>
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- Solitary

- Eccentric

- Geographic

- Multiloculated

- Fibrous matrix

- Small

- Cortical thinning

- Sclerotic border

Describe the lesion

<p>Describe the lesion</p>
55
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Non-Ossifying Fibroma

Diagnosis?

<p>Diagnosis?</p>
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Nothing

Next step?

<p>Next step?</p>
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- Anterolateral distal tibia

- Metaphysis

- Septation

- Cortical thinning

- Geographic

- Sclerotic border

- Fibrous matrix

Describe the lesion

<p>Describe the lesion</p>
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Non-Ossifying Fibroma

Diagnosis?

<p>Diagnosis?</p>
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- Look for fracture

- Refer to orthopedist

Next step?

<p>Next step?</p>
60
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- Humerus

- Central

- Diaphysis

- Geographic

- Cortical thinning

Describe the lesion

<p>Describe the lesion</p>
61
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Pathologic fracture

What complication has occurred?

<p>What complication has occurred?</p>
62
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Simple bone cyst

Most likely diagnosis?

<p>Most likely diagnosis?</p>
63
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Refer to orthopedist

Next step?

<p>Next step?</p>
64
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- Proximal fibula

- Metaphysis/diaphysis

- Eccentric

- Saccular ballooning of cortex

- Periosteal buttressing

Describe the lesion

<p>Describe the lesion</p>
65
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Aneurysmal bone cyst

Most likely diagnosis?

<p>Most likely diagnosis?</p>
66
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Refer to orthopedist

Next step?

<p>Next step?</p>
67
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- Fluid-Fluid Levels

- Aneurysmal bone cyst

- Are there any features that help you diagnose this lesion?

- What is the most likely diagnosis?

<p>- Are there any features that help you diagnose this lesion?</p><p>- What is the most likely diagnosis?</p>
68
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Bone chips

What has occurred?

<p>What has occurred?</p>
69
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- Body of calcaneus

- Geographic

- Lucent

- Central target sequestrum

Describe the lesion

<p>Describe the lesion</p>
70
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Intraosseous lipoma

Most likely diagnosis?

<p>Most likely diagnosis?</p>
71
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Refer to orthopedist or specialist

Next step?

<p>Next step?</p>
72
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Heel spur

What is going on with the posteroinferior calcaneus?

<p>What is going on with the posteroinferior calcaneus?</p>