DXI II EXAM 1 WITH QUESTIONS AND
VERIFIED ANSWERS
What is osteoma Age/Sex predilection? - ANSWER 10-50 Years Old, 20 Peak
3:1 Female
What is the most common location of an osteoma? - ANSWER Skull or Facial
Bones, especially frontal or ethmoid sinuses
What are the features of the lesion of an osteoma? - ANSWER Round or oval,
well-circumscribed, radioopaque
What can be the complications/ detrimental effects of an osteoma? - ANSWER
-Block sinus drainage, mucocele, sinusitis, headache, cosmetic deformity
What is the triad of Gardener's Syndrome? - ANSWER -Multiple osteomas
-Colonic polyposis (premalignant)
-Soft tissue fibromas
If a patient is found to have Gardener's syndrome, what should you do and why? -
ANSWER Have the colon checked for polyps as they can become malignant and
metastasize
What is age/sex predilection for an enostoma? - ANSWER Any ages, either sex,
more common in adults
Which bones would you expect to find an enostoma? - ANSWER ischium, sacrum,
proximal femur
Which aspect of long bone is an enostoma found in? - ANSWER metaphysis or
epiphysis, NOT diaphysis
Is an enostoma usually found in the skull? - ANSWER No
What complications will an enostoma present to the patient? - ANSWER None,
asymptomatic. Arises as an incidental finding
,How does an enostoma appear radiographically? - ANSWER Solitary area of
sclerosis w/ sharply demarcated margins. Thorn-like radiating spicules
What buzz term is often used to describe an enostoma's appearance? - ANSWER
Brush border
How big does an enostoma need to measure to be labeled a "giant bone island?" -
ANSWER greater than 1 cm
What can an enostoma look like and why? - ANSWER Can resemble blastic mets
due to lamellar bone in spongiosa
What is osteopoikilosis; where does it occur? - ANSWER -Multiple bone islands
-Near joints or on both sides of joints
What is age/sex predilection for osteoid osteoma? - ANSWER -10-25 years old
-2:1 male
Where is an osteoid osteoma most likely found? - ANSWER -50% in lower
extremities (femur or tibia)
-Less common in spine, but when present
--likes neural arch/posterior elements
--occurs 60% in lumbar spine
--can cause "ivory pedicle"
What are the features of an osteoid osteoma in the spine and what complications
can it cause? - ANSWER -Likes neural arch/posterior elements
-In lumbar spine 60% of the time
-Can cause ivory pedicle
-Can cause scoliosis with lesion on concave side
What are the features of the lesion of an osteoid osteoma? - ANSWER -Central,
lucent nidus <1cm in size (lucency could be obscured by sclerosis)
What will be the result of a bone scan on an osteoid osteoma? - ANSWER Double
,density sign!
(hot spot on a hot spot)
What is the potential DDX for an osteoid osteoma? - ANSWER Brodie's abcess
What is the age/sex predilection for an osteoblastoma? - ANSWER -Can occur
from 3-78 though the peak is from 10-20 years of age.
-2:1 male
Where is an osteoblastoma most likely to occur? - ANSWER -40% posterior
elements of spine. Frequently at T/L junction
-30% long bones - lower extremity
How does an osteoblastoma appear radiographically? - ANSWER -Expansive
nidus, lucent, cortical thinning.
-Nidus >2cm (often 2-10cm in long bones, 4-6cm in spine)
Where in long bones will an osteoblastoma appear? - ANSWER Diaphysis
If soft tissue is involved with an osteoblastoma, what can we likely deduce? -
ANSWER MALIGNANCY
What is the age/sex predilection for osteosarcoma? - ANSWER -10-25 years old
-2:1 male
How will a patient with an osteosarcoma likely present? - ANSWER -Painful
swelling, decreased ROM in adjacent joint
What bone-softening condition is often associated with osteosarcoma? - ANSWER
Paget's disease
Which bones is an osteosarcoma most often found? - ANSWER -80% in tubular
bones
-3-7% in spine
What are the patterns of an osteosarcoma lesion? - ANSWER -50% sclerotic
-25% lytic (most aggressive)
, -25% mixed
How does an osteosarcoma appear radiographically? - ANSWER -Long zone
-Cortical destruction
-Soft tissue expansion (often with calcification)
-Spiculated/Sunburst periosteal response
Does osteosarcoma generally generate a periosteal reaction? If so, what type? -
ANSWER Yes. Sunburst or Codman's triangle
Does osteosarcoma have a good treatment prognosis? Why or why not? -
ANSWER No, as it metastasizes early.
If an osteosarcoma metastasizes to the lungs, what term is used to describe its
appearance? - ANSWER Cannonball lung
What is an appropriate DDX for osteosarcoma? - ANSWER -Osteosarcoma
-Ewing's sarcoma
-Infection (osteomyelitis)
What are four different types of osteosarcoma? - ANSWER -Multicentric
-Parosteal
-Secondary
-Extraosseous
VERIFIED ANSWERS
What is osteoma Age/Sex predilection? - ANSWER 10-50 Years Old, 20 Peak
3:1 Female
What is the most common location of an osteoma? - ANSWER Skull or Facial
Bones, especially frontal or ethmoid sinuses
What are the features of the lesion of an osteoma? - ANSWER Round or oval,
well-circumscribed, radioopaque
What can be the complications/ detrimental effects of an osteoma? - ANSWER
-Block sinus drainage, mucocele, sinusitis, headache, cosmetic deformity
What is the triad of Gardener's Syndrome? - ANSWER -Multiple osteomas
-Colonic polyposis (premalignant)
-Soft tissue fibromas
If a patient is found to have Gardener's syndrome, what should you do and why? -
ANSWER Have the colon checked for polyps as they can become malignant and
metastasize
What is age/sex predilection for an enostoma? - ANSWER Any ages, either sex,
more common in adults
Which bones would you expect to find an enostoma? - ANSWER ischium, sacrum,
proximal femur
Which aspect of long bone is an enostoma found in? - ANSWER metaphysis or
epiphysis, NOT diaphysis
Is an enostoma usually found in the skull? - ANSWER No
What complications will an enostoma present to the patient? - ANSWER None,
asymptomatic. Arises as an incidental finding
,How does an enostoma appear radiographically? - ANSWER Solitary area of
sclerosis w/ sharply demarcated margins. Thorn-like radiating spicules
What buzz term is often used to describe an enostoma's appearance? - ANSWER
Brush border
How big does an enostoma need to measure to be labeled a "giant bone island?" -
ANSWER greater than 1 cm
What can an enostoma look like and why? - ANSWER Can resemble blastic mets
due to lamellar bone in spongiosa
What is osteopoikilosis; where does it occur? - ANSWER -Multiple bone islands
-Near joints or on both sides of joints
What is age/sex predilection for osteoid osteoma? - ANSWER -10-25 years old
-2:1 male
Where is an osteoid osteoma most likely found? - ANSWER -50% in lower
extremities (femur or tibia)
-Less common in spine, but when present
--likes neural arch/posterior elements
--occurs 60% in lumbar spine
--can cause "ivory pedicle"
What are the features of an osteoid osteoma in the spine and what complications
can it cause? - ANSWER -Likes neural arch/posterior elements
-In lumbar spine 60% of the time
-Can cause ivory pedicle
-Can cause scoliosis with lesion on concave side
What are the features of the lesion of an osteoid osteoma? - ANSWER -Central,
lucent nidus <1cm in size (lucency could be obscured by sclerosis)
What will be the result of a bone scan on an osteoid osteoma? - ANSWER Double
,density sign!
(hot spot on a hot spot)
What is the potential DDX for an osteoid osteoma? - ANSWER Brodie's abcess
What is the age/sex predilection for an osteoblastoma? - ANSWER -Can occur
from 3-78 though the peak is from 10-20 years of age.
-2:1 male
Where is an osteoblastoma most likely to occur? - ANSWER -40% posterior
elements of spine. Frequently at T/L junction
-30% long bones - lower extremity
How does an osteoblastoma appear radiographically? - ANSWER -Expansive
nidus, lucent, cortical thinning.
-Nidus >2cm (often 2-10cm in long bones, 4-6cm in spine)
Where in long bones will an osteoblastoma appear? - ANSWER Diaphysis
If soft tissue is involved with an osteoblastoma, what can we likely deduce? -
ANSWER MALIGNANCY
What is the age/sex predilection for osteosarcoma? - ANSWER -10-25 years old
-2:1 male
How will a patient with an osteosarcoma likely present? - ANSWER -Painful
swelling, decreased ROM in adjacent joint
What bone-softening condition is often associated with osteosarcoma? - ANSWER
Paget's disease
Which bones is an osteosarcoma most often found? - ANSWER -80% in tubular
bones
-3-7% in spine
What are the patterns of an osteosarcoma lesion? - ANSWER -50% sclerotic
-25% lytic (most aggressive)
, -25% mixed
How does an osteosarcoma appear radiographically? - ANSWER -Long zone
-Cortical destruction
-Soft tissue expansion (often with calcification)
-Spiculated/Sunburst periosteal response
Does osteosarcoma generally generate a periosteal reaction? If so, what type? -
ANSWER Yes. Sunburst or Codman's triangle
Does osteosarcoma have a good treatment prognosis? Why or why not? -
ANSWER No, as it metastasizes early.
If an osteosarcoma metastasizes to the lungs, what term is used to describe its
appearance? - ANSWER Cannonball lung
What is an appropriate DDX for osteosarcoma? - ANSWER -Osteosarcoma
-Ewing's sarcoma
-Infection (osteomyelitis)
What are four different types of osteosarcoma? - ANSWER -Multicentric
-Parosteal
-Secondary
-Extraosseous
