What is a characteristic X-ray pattern associated with osteosarcoma?
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A typical 'sunburst' pattern.
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What is a characteristic X-ray pattern associated with osteosarcoma?
A typical 'sunburst' pattern.
Where are bone tumors typically localized in a mature skeleton?
In the diaphysis of long tubular bones.
What is a characteristic X-ray feature of multiple myeloma?
Osteopenia.
What type of bone cancer is shown in the X-ray of the femur?
Osteosarcoma.
How does the structure of a typical long bone differ between adults and children?
Children have epiphyseal discs for growth, while adults have epiphyseal lines.
What imaging techniques are used to reveal the extent of a giant cell tumor?
CT and MRI.
Where are bone tumors typically localized in an immature skeleton?
In the metaphysis of long tubular bones.
What is multiple myeloma?
A type of cancer that affects plasma cells, which are a type of white blood cell found in the bone marrow.
What type of cells does multiple myeloma affect?
Plasma cells.
What is the diaphysis of a long bone?
The long shaft of the bone.
What imaging technique is required for initial staging of Ewing's sarcoma to check for pulmonary metastasis?
CT scan.
What is the primary imaging technique used for diagnosing osteosarcoma?
X-ray.
Which imaging method is used to identify soft tissue extension and marrow involvement in Ewing's sarcoma?
MRI.
What covers the epiphysis of a long bone?
Cartilage.
What is the first question to ask when studying an X-ray?
What is the clinical question or concern?
What type of fractures are commonly seen in multiple myeloma?
Vertebral compression fractures.
What does an X-ray show in relation to a giant cell tumor?
A giant cell tumor in the lower end of the radius bone in the wrist.
Where do expanding lesions typically occur in multiple myeloma?
In the ribs and pelvis.
What is the epiphyseal disc?
A growth plate found in long bones.
What are 'punched-out' areas in the context of multiple myeloma?
Areas seen in the skull and long bones on X-ray films.
What characteristic appearance is associated with benign bone tumors?
Characteristic 'soap-bubble' appearance.
What is the purpose of a biopsy in the context of bone tumors?
To obtain tissue for diagnosis.
What is the typical age group affected by Osteosarcoma?
Children, adolescents, and young adults under the age of 30.
What is the significance of the copyright notice?
It indicates the ownership of the work and the rights reserved by the copyright holder.
What type of pain is commonly associated with bone tumors?
Deep ache, especially nocturnal pain.
What are the most common sites for Osteosarcoma?
Long bone metaphyses, especially around the knee and proximal humerus.
What causes the effects on bone in multiple myeloma?
Marrow cell proliferation and increased osteoclastic activity.
How does Osteosarcoma spread?
Rapidly outwards to the periosteum and surrounding soft tissues.
What can sometimes cause a tumor to start hurting?
A history of trauma.
What type of training is provided for patients who undergo amputation due to osteosarcoma?
Training with prostheses.
What aspect of physical health does physiotherapy aim to maintain in patients with giant cell tumors?
Flexibility.
What is the purpose of imaging studies in a needle biopsy?
To help direct the needle to the tumor.
What effect does a growing bone tumor have on healthy tissue?
It destroys healthy tissue and weakens bone.
What is the metaphysis in a long bone?
The region between the diaphysis and epiphysis.
What anatomical area should be focused on in the X-ray?
Which specific bone or joint is being examined?
What percentage of malignant bone tumors does Ewing's sarcoma represent?
10-15%.
What is removed during an open biopsy?
Some tissue is surgically removed.
What is important to evaluate in the X-ray findings?
What are the characteristics of the bone lesion?
What is a common symptom of a giant cell tumor?
Pain at the nearest joint.
What should be considered regarding the patient's age?
What is the age of the patient, as it influences the differential diagnosis?
What limitation might be experienced due to a giant cell tumor?
Limited range of motion.
Why should biopsy procedures be delayed until after imaging studies?
Because biopsy may alter the CT and MRI appearances.
What condition related to calcium levels can occur in multiple myeloma?
Hypercalcemia.
What type of lesion is associated with osteosarcoma of the distal femur?
A permeative lesion.
Is a history of trauma common in patients with giant cell tumors?
Yes, it is not uncommon.
What is the purpose of a biopsy in bone tumor management?
To confirm diagnosis and assess the nature of the tumor.
What might be found during a physical examination of a giant cell tumor?
A palpable mass with warmth of the overlying tissues.
What are extracompartmental tumors (T2)?
Tumors where cancer has grown through the bone wall.
What does the term 'metastases' refer to?
Spread of cancer from one part of the body to another.
What does T3 indicate in the staging of bone tumors?
Discontinuous tumors in the primary bone site.
What are the most common sites for giant cell tumors?
Epiphyses ends of distal femur, proximal tibia, and distal radius.
What is the Codman triangle in relation to bone tumors?
A triangular area of new bone formation rising from the bone.
What does copyright protect?
Original works of authorship, including literary, dramatic, musical, and artistic works.
What has increased long-term survival rates for Ewing's sarcoma to greater than 50%?
The development of multi-disciplinary therapy including chemotherapy, radiation, and surgery.
Where are plasma cells found?
In the bone marrow.
What causes bone tumors to develop?
When cells within a bone divide uncontrollably, forming a lump or mass of abnormal tissue.
What are some symptoms of bone tumors?
Pain, swelling, history of trauma, neurological symptoms, and pathological fractures.
Are most bone tumors benign or malignant?
Most bone tumors are benign.
Which imaging technique shows the extent of the tumor in osteosarcoma?
MRI and CT scans.
What type of cancer is Ewing's sarcoma?
A type of primary bone cancer.
What are giant cells formed by?
The fusion of several cells.
What role does physiotherapy play in osteochondroma treatment?
To maintain functional mobility, including range of motion, strength, and restoring proper biomechanics post-operatively.
What type of cells is Ewing's sarcoma believed to arise from?
Endothelial cells in the bone marrow.
What characteristic do giant cells exhibit when viewed under a microscope?
They show multiple nuclei.
What is the typical cure rate for multiple myeloma in the early stages of metastasis?
70%.
What is a common immune system presentation in multiple myeloma?
Recurrent bacterial infections.
What is a key principle in the management of bone tumors?
Multidisciplinary team approach.
What percentage of pediatric bone tumors does Ewing's sarcoma account for?
Up to 45%.
What are the possible appearances of periosteal reaction in Ewing's sarcoma?
'Onion skin' or 'sunburst' appearance.
At what age range does Ewing's sarcoma most commonly occur?
Between the ages of 10 to 20 years.
What other imaging modalities should be considered?
Should MRI, CT, or bone scans be utilized for further evaluation?
Which gender is more affected by Ewing's sarcoma?
Males are affected more than females.
What is the treatment for inoperable or multiply recurrent giant cell tumors?
Radiotherapy, which carries a significant risk of malignant transformation.
What might be observed during a physical examination of Osteosarcoma?
Swelling or a mass.
What is the staging system used for primary malignant tumors of bone?
American Joint Committee on Cancer Staging System.
What radiological finding is characteristic of multiple myeloma?
Multiple 'punched-out' lytic lesions.
What unusual movement might occur due to osteochondroma?
Snapping of tendon over the tumor.
What is a potential limitation in movement caused by osteochondroma?
Restricted range of motion.
What does an X-ray reveal in cases of osteochondroma?
A well-defined exostosis emerging from the metaphysis, co-extensive with the parent bone.
Where was the swelling located in the osteochondroma case?
In the lower thigh on the right side.
What happens to the epiphyseal disc in adults?
It becomes an epiphyseal line, indicating that growth has stopped.
What type of exercise programs may be beneficial for individuals with multiple myeloma?
Short, low-intensity exercise programs.
Which gender is more frequently affected by Osteosarcoma?
Males.
What is the treatment approach for non-symptomatic osteochondroma?
Observation and regular monitoring.
What year is mentioned in the copyright notice?
When is pain medication used for osteochondroma?
Only if symptoms of pain are present.
Who holds the copyright for the mentioned work?
The Hong Kong Polytechnic University.
What are the common bone effects associated with multiple myeloma?
Osteoporosis and lytic lesions throughout the skeleton.
What does 'All Rights Reserved' imply?
The copyright holder retains all rights provided by copyright law.
What is a common blood test finding in multiple myeloma?
Anemia.
What are the most common sites for osteochondroma?
Distal femur, proximal humerus, and proximal tibia.
How does the presence of metastasis affect bone cancer prognosis?
It generally worsens the prognosis.
What procedure is always carried out before starting treatment for osteosarcoma?
Biopsy.
What are typical findings of Ewing's sarcoma on X-rays?
An area of bone destruction predominantly in the mid-diaphysis.
What condition can occur due to affected bones leaking calcium in multiple myeloma?
Hypercalcaemia.
What effect does Osteosarcoma have on limb movement?
Decreased movement of the affected limb.
In what situation might amputation be considered for osteosarcoma patients?
When it may be more appropriate in some cases.
How are benign, asymptomatic lesions typically managed?
Monitoring and biopsy.
What is the MSTS (Enneking) system used for?
Staging of bone tumors.
What is the management approach for benign, symptomatic, or enlarging tumors?
Local (marginal) excision or curettage for benign cysts.
What physical sign may indicate a giant cell tumor?
Swelling.
What protein is detected in urine protein electrophoresis in 50% of multiple myeloma patients?
Bence Jones protein.
What sensations might a patient experience with osteochondroma?
Numbness and tingling.
What does G1 represent in histological grading?
Low grade, well differentiated.
What causes numbness, tingling, or paralysis in Ewing's sarcoma patients?
Nerve compression from the tumor.
What is the focus of the Enneking Staging System?
Primary malignant bone tumors.
What is the age and gender of a typical osteochondroma patient mentioned?
Male, 25 years old.
Can giant cell tumors affect other areas besides the limbs?
Yes, they can also affect the sacrum and vertebrae.
What type of tumor is Osteosarcoma?
A highly malignant tumor arising within the bone.
What are the Enneking stages used for?
To classify bone tumors based on their growth and spread.
What is a critical intervention for individuals at risk for pathologic fractures?
Implementation of fall prevention programs.
What might be observed regarding the mass in a bone tumor?
The mass can be discrete or ill-defined, soft or hard, and may be pulsatile.
What factors influence the prognosis of bone cancer?
Overall stage of disease, presence of metastasis, skip lesions, histologic grade, and tumor size.
What percentage of all benign bone tumors is osteochondroma responsible for?
Approximately 35%.
What is a common treatment for multiple myeloma?
Chemotherapy.
What can malignant bone tumors do?
They can metastasize.
What is the epiphyseal disc also known as?
Growth plate or physeal plate.
What has been the trend in the long-term survival rate of osteosarcoma in recent years?
Improved to over 60%.
What should be taught to a child if amputation is performed due to Ewing's sarcoma?
How to use the prosthesis.
What type of bone tumors does the Enneking Staging System primarily address?
Primary benign bone tumors.
What are typical symptoms of osteosarcoma?
Swelling or a mass and limited range of motion in the nearby joint.
What procedure is performed to assess bone marrow involvement in Ewing's sarcoma?
Bone marrow biopsy.
What is a treatment option for patients with severe multiple myeloma?
Stem cell transplant.
What is a characteristic X-ray finding in osteosarcoma?
A 'cumulus cloud' appearance, which is a white, cloud-like lesion.
How does multiple myeloma affect the circulatory system?
It causes anemia, leading to weakness and fatigue.
What type of fracture may be present in Osteosarcoma patients?
Pathological fracture.
What characterizes aggressive lesions in bone tumors?
They exhibit rapid growth and potential for invasion.
What is the 'sunburst' pattern in osteosarcoma?
Formation of new bone that radiates outwards from the cortex.
What is a common symptom of osteochondroma?
A painless mass near a joint, often in the knee or shoulder.
Why is kidney function important in determining prognosis for multiple myeloma?
It is one of the factors that can influence patient outcomes.
What are benign bone tumors?
Tumors that are non-cancerous and typically do not spread.
What are common symptoms of Ewing's sarcoma?
Pain, warm and tender swelling, generalized illness, fever, numbness, tingling, or paralysis.
What urinary system complications can arise from multiple myeloma?
Renal insufficiency and kidney stones.
What characterizes high grade (G2) malignant bone tumors?
Very aggressive and metastasize early.
What changes might occur in blood flow due to osteochondroma?
Changes in blood flow can occur.
What type of pain is commonly reported in multiple myeloma patients?
Back pain.
What is a key focus of physiotherapy in multiple myeloma?
Prevention and management of skeletal muscle wasting, cancer-related fatigue, and pathologic fractures.
How can age be useful in the context of bone tumors?
Age may be a useful clue in diagnosing bone tumors.
What is an osteochondroma?
An overgrowth of cartilage at the edge of the physeal plate that develops into a bony protuberance still covered by a cap of cartilage.
What percentage of all bone tumors does osteochondroma account for?
10-15%.
What characterizes extracompartmental bone cancer?
The cancer has grown through the bone wall.
What impairments does physiotherapy aim to correct in osteosarcoma patients?
Balance and coordination impairments.
What does the overall stage of bone cancer incorporate?
It incorporates factors like presence of metastasis, skip lesions, histologic grade, and tumor size.
What are the indications for surgery in osteochondroma cases?
Pain with activity, pressure on a nerve or blood vessel, presence of a larger cartilage cap, and fully matured bone growth.
What are skip lesions in the context of bone cancer?
Discontinuous lesions within the same bone.
What is the purpose of a Positron Emission Tomography (PET) scan in osteosarcoma diagnosis?
To detect small tumors that have spread.
What imaging technique is commonly used to diagnose Ewing's sarcoma?
X-rays.
What is the purpose of a PET scan in the context of Ewing's sarcoma?
To find small tumors and may show multiple areas of 'hot' lesions.
Is multiple myeloma common before the age of 40?
No, it is uncommon before the age of 40.
What physical symptom may accompany Osteosarcoma?
Swelling.
What type of tumor is associated with giant cells?
Giant cell tumor of bone.
What are the characteristics of giant cell tumors?
Well-confined, slow-growing lesions with benign histology.
Why is tumor size important in assessing bone cancer prognosis?
Larger tumors may indicate a more advanced disease and poorer prognosis.
What are active lesions in the context of bone tumors?
Bone tumors that show signs of growth or activity.
What does the presence of a Codman triangle indicate in osteosarcoma?
An elevation of the periosteum from the surface of the bone.
What skeletal system issues are associated with multiple myeloma?
Bone destruction, localized bone pain, pathological fractures, and vertebral collapse.
What is a physical examination finding in Osteosarcoma?
Tenderness over the bone.
What are the two grades of malignant bone tumors?
Low grade (G1) and high grade (G2).
What is done for suspected malignant tumors?
More detailed examination to confirm diagnosis and staging.
Which bones are primarily affected by Ewing's sarcoma?
Long tubular bones (e.g., femur, tibia).
What is intracystic curettage?
A treatment method for benign bone tumors involving scraping out the tumor.
What general condition of the bones is observed in multiple myeloma?
Generalised osteopenia.
What are intracompartmental tumors (T1)?
Tumors that are still inside the bone.
What appearance might large osteochondroma lesions have?
A 'cauliflower' appearance, with degeneration and calcification in the center of the cartilage cap.
What does M1a indicate in metastasis classification?
Lung-only metastases.
What is a common characteristic of bone tumors regarding symptoms?
Patients may be completely asymptomatic until the abnormality is discovered on X-ray.
What changes in the overlying skin may indicate a bone tumor?
Changes such as warmth in the skin.
What characterizes intracompartmental bone cancer?
The cancer has not grown through the bone wall or spread to other parts of the body.
What is an important aspect of physiotherapy for managing osteosarcoma?
Pain control.
What are the enlarged ends of a long bone called?
Epiphysis.
How can a bone tumor affect nearby joints?
It may cause effusion or limitation of movement.
What is a common physical examination finding in giant cell tumors?
A palpable mass with warmth of the overlying tissues.
At what age range does osteochondroma most often occur?
Between ages 10 and 30.
Why must caution be taken during post-operative physiotherapy for Ewing's sarcoma?
Due to the impaired healing process caused by chemotherapy.
What is the MSTS (Enneking) system used for?
Staging of bone tumors.
What is a common physical examination finding in osteosarcoma?
Tenderness over the bone.
What characteristic appearance may giant cell tumors show on X-rays?
A 'soap-bubble' appearance.
What role do corticosteroids play in multiple myeloma treatment?
They are used as part of the treatment regimen.
Which gender is more affected by multiple myeloma?
Males are affected more than females.
What happens to the cortex in giant cell tumors?
The cortex is thin.
What is a significant risk for patients with multiple myeloma?
They are prone to infections.
Where is a giant cell tumor commonly located in the body?
In the lower end of the thighbone.
What prophylactic measures can help prevent infections in multiple myeloma patients?
Influenza vaccine, antibiotics during chemotherapy induction, and intravenous immunoglobulin for recurrent infections.
What is a common urinary finding in patients with multiple myeloma?
Proteinuria.
What is important for pain management in multiple myeloma?
Pain control and treatment of pathological fractures.
What is the significance of comparing previous imaging?
How do the current findings compare to previous imaging studies?
What skeletal condition is often seen in patients with multiple myeloma?
Osteoporosis.
What are some treatment options for malignant bone tumors?
Amputation, limb-sparing operations, and different types of adjuvant therapy (chemotherapy, radiotherapy).
What serious complication can occur with a giant cell tumor?
Pathological fracture.
Are giant cell tumors cancerous?
They are aggressive non-cancerous tumors.
What does T2 indicate in tumor size classification?
Tumors greater than 8 cm.
What is a common physical examination finding in bone tumors?
Swelling or tenderness in the area of the tumor.
What is a key focus of physiotherapy for osteosarcoma patients?
Early postsurgical mobility training, strength and endurance restoration.
What role does physiotherapy play in the treatment of giant cell tumors?
It helps in pain reduction, improved mobility, and restoring previous levels of function.
What is the typical treatment sequence for Ewing's sarcoma?
Preoperative chemotherapy followed by surgical resection and maintenance chemotherapy, along with adjuvant radiotherapy.
How can physiotherapy improve a patient's daily activities?
By improving cardiovascular fitness to prevent fatigue.
What is the focus of pre-operative physiotherapy for Ewing's sarcoma?
Strengthening of the affected limb and aerobic conditioning.
What is one goal of physiotherapy related to joint health?
To decrease joint stiffness.
What is a needle biopsy?
A procedure where a needle is inserted into the tumor to remove tissue under local anesthetic.
What does MRI often reveal in cases of Ewing's sarcoma?
A large soft tissue component.
What supportive measures are important in treating multiple myeloma?
Correcting fluid balance, anemia, and hypercalcemia.
What should be assessed regarding the patient's history?
What is the patient's medical history and symptoms?
What renal issue is associated with multiple myeloma?
Renal insufficiency, indicated by raised creatinine levels and electrolyte disturbances.
Can osteochondromas occur in flat bones?
Yes, they can also occur in flat bones such as the ilium and scapula.
What is the significance of histologic grade in bone cancer prognosis?
It helps determine the aggressiveness of the tumor.
What is the common treatment approach for osteosarcoma?
Combination of chemotherapy and surgery.
What can the lesion in Ewing's sarcoma be like?
It may be purely lytic or have variable amounts of reactive new bone formation.
What is the overall 5-year survival rate for multiple myeloma if the disease has spread?
Around 35%.
What is the treatment for well-confined giant cell tumors?
Curettage and packing with bone chips.
What factors determine the prognosis for patients with multiple myeloma?
Stage of the disease, age of patient, health condition at diagnosis, kidney function, growth rate of cancer cells, and certain chromosome changes.
What is the treatment for more aggressive giant cell tumors or recurrent lesions?
Excision followed by bone grafting or prosthetic replacement.
How does the stage of the disease affect prognosis in multiple myeloma?
It is one of the key factors determining prognosis.
What is the significance of staging in bone tumors?
It helps determine the treatment approach and prognosis.
What characterizes low grade (G1) malignant bone tumors?
Moderately aggressive.
In which age group do giant cell tumors typically occur?
Young adults, approximately 20 to 40 years.
Which gender is more commonly affected by giant cell tumors?
Female.
What is a potential risk associated with giant cell tumors?
They have the potential to transform into an osteosarcoma.
What percentage of giant cell tumors can metastasize to the lung?
About 5%.
What is an overview of bone tumors?
A general summary of the types, characteristics, and staging of bone tumors.
What type of lesion is typically seen in giant cell tumors on X-rays?
A destructive (lytic) epiphyseal/metaphyseal lesion.
At what age does multiple myeloma usually occur?
Around the age of 60.
What is a common symptom of Osteosarcoma?
Pain that may worsen at night and gradually increases in severity.
Who may be the first to relate the signs and symptoms experienced by a patient with giant cell tumors?
The physiotherapist.
What type of anesthesia is used for an open biopsy?
General anesthesia.
What is the typical border appearance of giant cell tumors on X-rays?
Usually have a nonsclerotic and sharply defined border.
What is the lowest grade in the Enneking Staging System?
Latent lesions.
What is often elevated in multiple myeloma and indicates inflammation?
Erythrocyte sedimentation rate (ESR).
What other tests may be conducted alongside biopsies?
Blood and urine tests.
What specific protein is identified in serum protein electrophoresis for multiple myeloma?
M protein.
What percentage of all primary bone tumors do giant cell tumors account for?
5%.
What percentage of benign bone tumors are giant cell tumors?
20%.
How does Osteosarcoma affect the range of motion in nearby joints?
It may cause a limited range of motion.
What is an overview of bone tumors?
A general understanding of the types, characteristics, and implications of bone tumors.
What does G4 represent in histological grading?
High grade, undifferentiated.
What neurological issue can occur due to multiple myeloma?
Spinal cord compression.
What is the size classification for tumors that are 8 cm or less?
T1.
What does M1b indicate in metastasis classification?
Metastases to other distant sites, including distant lymph nodes.
What is the difference between primary and secondary bone cancer?
Primary bone cancer originates from the bone, while secondary bone cancer originates from other body parts, and spreads to other organs, like lung cancer.
