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Summary

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Description

General Osteogenic Benign Osteoid Osteoma

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Osteoblastoma

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Osteoma

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Clinical

Peak age range = 10-25 years Males 2:1 females Can affect any bone, but m.c affects the femur and tibia When it affects the spine, it likes the posterior arch Highly vascularized and innervated

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Peak age range = 10-20 years Males 2:1 females Likes the thoracolumbar spine (posterior arch), femur and tibia Rarely become malignant

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Not as painful as osteoid osteoma Pain not necessarily relieved by aspirin Most have painful scoliosis May see signs of neurologic compression

Females 3:1 males Almost exclusively found in the head (sinuses- esp. frontal and ethmoid, skull, mandible)

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Usually asymptomatic Can cause cosmetic deformity or obstruction of a sinus Gardner’s syndrome = multiple osteomas, colonic polyposis, soft tissue fibromas Colonic polyps have high incidence of malignancy Usually asymptomatic Can cause a hard, palpable mass Can cause neural or vascular compromise Can fracture Increase in size or pain in adulthood suggests degeneration

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Osteochondroma

Hereditary Multiple Exostosis (HME)

Enostoma

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Patient complains of sharp pain, worse at night, classically relieved by aspirin Painful scoliosis

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M.c. Benign “tumour” of the skeleton Peak age range = < 20 years Males 2:1 females M.c affect the knee and hip regions Malignant degeneration occurs in incidence closer to axial skeleton)

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Inherited (HME) or non-inherited (osteochondromatosis) disorder - multiple osteochondromas Bilateral Growth disturbances Malignant degeneration occurs in 5-25% of cases M.c around the knees, but can affect any region Islands of cortical bone within the medullary Asymptomatic cavity Found in any bone except the skull. M.c in femur and ilium May be solitary or multiple

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Radiographic

DDx

Usually cortical Lucent nidus 2cm in diameter Less reactive sclerosis than osteoid osteoma Expansile, especially in the spine *If the posterior arch is affecting and the patient is under 30, then osteoblastoma and aneurysmal bone cyst must be considered Round to oval homogeneous opacity arising from cortex or within sinus Usually restoration Lesions in the long bones are usually diaphyseal and geographic, but can be permiative

Paget’s disease Any soap-bubbly lesion also a great imitator of bone disease

Any benign soap bubbly lesion Osteomyelitis Ewing’s sarcoma Metastasis Leukemia...