Xray Pathologies

Question 1

Benign Bone Tumor characteristics:

Answer 1

1. Encapsulated
2. Short Transition Zone
3. Geographic
4. Incidental Finding

Question 2

Unicameral Bone Cyst

Answer 2

aka SBC (simple bone cyst)

CENTRALLY located!!

Question 3

Aneurysmal Bone Cyst

Answer 3

aka ABC

BLOOD filled

Question 4

Giant Cell Tumor (GCT)

Answer 4

Epiphyseal location
20-40
QUASI-MALIGNANT (this is ONLY a characteristic of GCT)
BBT

Question 5

Chondroblastoma

Question 6

Osteoid Osteoma

Answer 6

Night pain relieved by aspirin!!!
Radiolucent central nidus w/ severe reactive sclerosis
BBT

Question 7

Brodies Abcess

Answer 7

aka Chronic Osteomyelitis

appears like Osteoid Osteoma
BBT

Question 8

Brodies Abcess

Answer 8

aka Chronic Osteomyelitis

appears like Osteoid Osteoma

Question 9

Enchondroma

Answer 9

MC BBT of hand
Multiple enchondromas = Ollier’s Disease
w/ ST calcification = Maffucci’s Syndrome

Question 10

Enostoma

Answer 10

Bone island

BBT

Question 11

Osteopoikilosis

Answer 11

Multiple bone islands

BBT

Question 12

Osteopoikilosis

Answer 12

Multiple bone islands

Question 13

Osteoblastoma

Answer 13

MC BBT neural arch

Question 14

Fibrous Dysplasia

Answer 14

BBT
Monostotic Form = 70% –> THICK RIND SIGN
Polystotic Form = 30%

• Deformities: Saber Shin Tibia (bowing tibia) + Sheppard’s Crook (bowing femur)
• Ground glass appearance
• !! “Cafe au lait” spots with “Coast of Maine” appearance

Question 15

Unicameral Bone Cyst

Answer 15

aka SBC (simple bone cyst)

CENTRALLY located!!

Question 16

Aneurysmal Bone Cyst

Answer 16

aka ABC

BLOOD filled

Question 17

Giant Cell Tumor (GCT)

Answer 17

Epiphyseal location
20-40
QUASI-MALIGNANT (this is ONLY a characteristic of GCT)

Question 18

Chondroblastoma

Question 19

Osteoid Osteoma

Answer 19

Night pain relieved by aspirin!!!

Radiolucent central nidus w/ severe reactive sclerosis

Question 20

Brodies Abcess

Answer 20

aka Chronic Osteomyelitis

appears like Osteoid Osteoma

Question 21

Enchondroma

Answer 21

MC BBT of hand
Multiple enchondromas = Ollier’s Disease
w/ ST calcification = Maffucci’s Syndrome

Question 22

Pagets

Answer 22

aka Osteitis Deformans

• Males >50
• Picture Frame Vertebra!!!
• Stages: Lytic or Destructive –>Mixed –>Sclerotic –> Malignant (osteosarc –> only way older person can have it)
• Bone expansion, bowing deformities, cotton wool, blades of grass, sheaves of wheat, brim sign, osteoporosis circumscripta

Labs:

1) Alkaline Phosphatase increase
2) URINARY HYDROXYPROLINE!!

Question 23

Enostoma

Answer 23

Bone island

Question 24

Osteopoikilosis

Answer 24

Multiple bone islands

Question 25

Osteoblastoma

Answer 25

MC BBT neural arch

Question 26

Osteoma

Answer 26

MC BBT skull | MC in frontal sinus seen on CALDWELL PROJECTION!!!

Question 27

Fibrous Dysplasia

Answer 27

Monostotic Form = 70% --> THICK RIND SIGN Polystotic Form = 30% - Deformities: Saber Shin Tibia (bowing tibia) + Sheppard's Crook (bowing femur) - Ground glass appearance - !! "Cafe au lait" spots with "Coast of Maine" appearance

Question 28

Neurofibromatosis

Answer 28

BBT - Posterior VB scalloping - !! "Cafe au lait" spots with "Coast of California" appearance - Hypertension, Neurodeficits, Seizures

Question 29

Multiple myeloma

Answer 29

aka Plasma Cell Sarcoma aka Hematopoietic Disease ``` >50 CACHEXIA (wasting away)!! HX of infection MC primary malignancy of bone "Rain Drop Skull" !!!! (punched out lesions) ``` LABS: 1) m spike IEP 2) Reversed Albumin/Globulin Ratio 3) Bence-Jones Proteinuria 4) elevated ESR * * Cold Bone Scan**

Question 30

METS (lytic/blastic)

Answer 30

MC malignant tumor of BONE

Question 31

Lytic METs

Answer 31

>40 (unex wt loss + bone pain at night) Owl Wink / Blind Vertebra!!! "Swiss Cheese" Skull appearance!!! Lab: ALKALINE phosphatase !!!

Question 32

Hodgkin's Disease

Answer 32

mc mets in 20-40 Ivory White Vertebra!!! Anterior VB scalloping!!! Reed Sternberg Cells

Question 33

Ivory White Vertebra

Answer 33

1) Hodgkins 2) Blastic METs 3) Pagets

Question 34

Blastic METS

Answer 34

>40 Ivory White Vertebra Alkaline Phosphatase

Question 35

Pagets

Answer 35

aka Osteitis Deformans Males