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PRIMARY TUMOURS (OTHER MALIGNANT (MULTIPLE MYELOMA 50-70yo male, mc TL…
PRIMARY TUMOURS
OSTEOGENIC
BENIGN
OSTEOID OSTEOMA
males,10-25yo, mc femur, tibia, posterior arch of Ts in SP + TVP, pain relieved by aspirin, lucent nidus <1cm, reactive sclerosis
OSTEOBLASTOMA
males, 10-20yo, TL spine posterior arch, femur, tibia, not as painful as OO, not relieved by aspirin, nidus >2cm, less reactive sclerosis
OSTEOMA
female, head, sinuses, skull, around oval opacity, <2cm
OSTEOCHONDROMA
mc benign tumour of skeleton, <20yo, male, knee, hips 1) Pedunculated exostosis, cauliflower 2) Sessile, broad based, widen femoral neck
HEREDITARY MULTIPLE EXOSTOSIS
BL symmetrical, multiple osteochondromas, malignant degeneration, knee
ENOSTOMA
any bone except skull, mc femur, ilium, solitary small multiple oval round opacity in medullary bone, brush border
MALIGNANT
PRIMARY OSTEOSARCOMA
produce osteoid, 10-25yo, male, mc Resnick (conventional), metastatise in lungs, increase alkaline phosphatase, mc knee
3 PATTERNS
mixed, blastic, lytic; ill defined, dense radiopacity, Codman's triangle,
SECONDARY OSTEOSARCOMA
Paget's, fibrous dysplasia, enchondromatosis / Ollier's, pre-existing lesion
CHONDROGENIC
BENIGN
ENCHONDROMA
10-30yo males, mc hand, asymtomatic, digit enlarged, geographic, expansile, well defined margins, leave me alone, Ca++, eccentric
OLLIER'S DX / ENCHONDROMATOSIS
multiple enchondromas, high malignant, solitary
CHONDROBLASTOMA
10-25yo male, mc knee, well defined, eccentric, geographic lucency, epiphyseal
CHONDROMYXOID FIBROMA
10-30yo, rare, mc proximal tibia, soap bubbly Ddx ABC
MALIGNANT
PRIMARY CHONDROSARCOMA
40-60yo, male, mc pelvis, femur, tibia, large lucent ill defined, expansile, calcification
SECONDARY CHONDROSARCOMA
arise from pre existing bns
BONE INFARCT
serpentuous
FIBROGENIC
BENIGN
FIBROUS CORTICAL DEFECT
8-10yo, male, asymptomatic, metaphysis, cortex
NON-OSSIFYING FIBROMA
8-20yo male, mc tibia, meta diaphyseal, endosteal scalloping, soap bubbly
MALIGNANT
PRIMARY FIBROSARCOMA
30-50yo, male, mc knee, pelvis, very destructive, metaphyseal
SECONDARY FIBROSARCOMA
mc primary lesions: Paget's, bone infarct, fibrous dysplasia
OTHER BENIGN
HARMANGIOMA
adult female, skull (sand-dollar, trabeculae), TL junction, mc benign tumour of spine, solitary
SIMPLE BONE CYST
3-14yo, male, mc proximal humerus, fluid-filled cyst, cystic lucency,
fallen fragment sign
, soap bubbly, bone chips
ANEURYSMAL BONE CYST
5-20yo, female, mc knee, highly expansile, geographic lucency, metaphysis
QUASIMALIGNANT
GIANT CELL TUMOUR
20-40yo female, mc knee, distal radius, sacrum
subarticular extension
, destructive
OTHER MALIGNANT
MULTIPLE MYELOMA
50-70yo male, mc TL marrow, back pain, osteopaenia, rain drop skull
SOLITARY PLASMACYTOMA
40-50yo, precursor to MM, mc mandible, ilium, vertebrae
LYMPHOMA NON HODGKIN'S
most common primary malignant bone tumour, 20-40yo, male, m,c knee, humerus,
ivory vertebra
EWING'S SARCOMA
10-20yo, appendicular, wide zone transition, laminated periosteal reaction, Codman Triangle, diaphyseal