Cone-shaped epiphyses
Last updated by drk on 07/07/2008 12:35 AM (Read: 189 times)
Cone-shaped epiphyses may occur in normal children and are unrelated to any skeletal dysplasia or arthropathy.
Coned epiphyses can be result of premature closure of the central portion of the physis, following which the peripheral portion of the physis continue to grow.
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Glenolabral articular disruption (GLAD) lesion
Last updated by drk on 06/23/2008 12:32 AM (Read: 426 times)
The GLAD lesion as described by Neviaser is a superficial tear of the anteroinferior labrum in combination with an articular cartilage lesion of the anterior inferior quadrant of the glenoid. The injury is thought to result from glenohumeral impaction while the arm is abducted and externally rotated.
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Osteosarcoma conventional
Last updated by drk on 06/23/2008 12:31 AM (Read: 324 times)
Osteosarcoma is the most common malignant primary bone tumor. It tends to occur in children and young adults typically 10-25 or 30 years of age. Osteosarcomas also tend to occur in patients in the sixth decade, likely related to malignant degeneration of Paget’s disease. The most common of osteosarcoma is the Conventional Osteosarcoma which accounts for 75% of cases. The distal femur and proximal tibia are the bones most commonly involved, followed by the humerus and iliac wing. Conventional osteosarcoma is typically located around the knee (commonly arise in the metadiaphysis) and is a very aggressive lesion associated with a soft tissue mass, cortical destruction, a permeative pattern of bone change and wide zone of transition. Periosteal reaction typically presents with a Codman’s triangle or sunburst pattern. At least 90% of conventional osteosarcomas produce osteoid matrix in variable quantities which alters their radiographic appearance.
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Osteosarcoma of the Jaw (Gnathic Osteosarcoma)
Last updated by drk on 06/23/2008 12:30 AM (Read: 350 times)
Gnathic Osteosarcoma of the mandible and maxilla constitute 6%-9% of all osteosarcomas. It is considered a distinct category because of its predilection to affect patients in the fourth decade. It has been reported with pre - existing conditions including radiation therapy, Paget's disease and fibrous dysplasia.
Lesions affect the alveolar ridge, maxillary antrum, and body of the mandible. At histologic analysis, the lesions are often predominantly chondroblastic. The radiologic appearance of gnathic osteosarcoma is similar to that of conventional osteosarcoma, with evidence of osteoid matrix, aggressive periosteal reaction in mandibular lesions, and soft-tissue cxtension. CT is the optimal modality for detecting areas of mineralized osteoid and periosteal reaction. MR imaging shows both intramedullary involvement and soft tissue mass which are advocated for staging workup.
Thanks to Dr. Shafi for providing this case.
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Unicameral bone cyst (UBC) or Simple bone cyst
Last updated by drk on 05/17/2008 12:07 AM (Read: 529 times)
Unicameral bone cyst present in the 1st and 2nd decades of life. Very rarely can be seen in older age like in our case. Majority of unicameral bone cysts occur in the proximal humerus and proximal femur (94%). Typically it is centrally located in metaphysis. It often leads to thinning of adjacent cortex of bone such that fracture may occur. Such a fracture is often associated with a fracture fragment which settles dependently within the cystic space. This has been called the "fallen fragment" sign. Usually UBC does not demostrate septation or loculation. Zone of transition is narrow with thin rim of non reactive bone. Without fracture periosteal reaction is not present.
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