Orthopedics 5th year, 7th/part two & 8th/part one lectures (Dr. Bakhtyar)
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The document discusses several bone tumors and conditions. It describes aneurysmal bone cyst as a cyst containing clotted blood and giant cells that commonly causes pain, swelling and can recur after treatment. It also describes giant cell tumor as a tumor of uncertain origin that typically affects young adults and may be benign, locally invasive, or metastasize. Primary malignant bone tumors discussed include osteosarcoma, which arises from inside bone and spreads rapidly, and Ewings sarcoma, which typically causes pain and swelling in adolescents. Metastatic bone disease is also summarized, noting its most common primary sources and sites of metastasis, as well as its clinical presentations and treatments.
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Volume 9
The document provides details on several cases of bone cysts, including unicameral bone cysts and aneurysmal bone cysts. It describes the typical presentation, characteristics, treatment approaches, and outcomes for each type of cyst. Radiographic images and histological photomicrographs are included to illustrate features of the cysts.
Ortho Patho Meet on Aneurysmal Bone Cyst by Dr. Saumya Agarwal
Ortho Patho Meet on Aneurysmal Bone Cyst by Dr. Saumya AgarwalCentral Institute of Orthopaedics, Safdarjang Hospital and VMMC, New Delhi
A 13-year-old female presented with a 6 month history of pain and swelling in her right thigh. On examination, a solitary 6x8 cm swelling was observed on the medial aspect of the right thigh. Imaging revealed an expansile osteolytic lesion in the femur diaphysis. Differential diagnoses included unicameral bone cyst, aneurysmal bone cyst, and telangiectatic osteosarcoma. Histopathology of a biopsy was consistent with aneurysmal bone cyst, which are benign, expansile lesions composed of blood filled spaces most commonly seen in children and adolescents. Surgical curettage and bone grafting is the traditional treatment, with a recurrence rate of around 20%.Giant cell tumour &Aneurysmal bone cyst
1. Giant cell tumour is a common benign bone tumour that typically affects people aged 20-50. It most commonly occurs around the knee and wrist in a solitary, eccentric lesion without sclerosis or well-defined margins.
2. Aneurysmal bone cyst usually affects children and adolescents under 20 and can occur throughout the body, including the long bones, spine and sacrum. It presents as a well-defined, expansile lytic lesion with thin sclerotic margins and may contain fluid-fluid levels.
3. The treatments for both tumours include curettage, but aneurysmal bone cyst may also be treated with embolisation or fibrosing agents while giant cell tumour can sometimes be treated
Simple bone cyst
Simple bone cysts, also known as unicameral bone cysts, are benign bone lesions of unknown cause that typically occur in the metaphysis of long bones like the proximal humerus and femur in children and adolescents. They appear on x-ray as areas of translucency in the bone and often cause pain, swelling or pathological fractures. Treatment involves curettage and bone grafting if the risk of fracture is high or steroid injections if the cyst is small with a low fracture risk.
Chondroblastoma
Chondroblastoma is a rare benign tumor that develops from cartilage germ cells, most commonly affecting the epiphysis of long bones in teenagers before growth plate closure. It appears lytic with punctate calcification on x-ray and shows clear borders and surrounding edema on MRI. Microscopically it contains islands of chondroblasts with chicken wire calcification and multinucleated giant cells. Treatment involves curettage with bone grafting, and it has a low recurrence rate with marginal excision but high recurrence with intra-capsular curettage.
Aneurysmal bone cyst
Locally destructive, blood-filled reactive lesions of bone and are not considered to be true neoplasm.
Simple bone cyst (unicameral)
Simple bone cysts, also known as unicameral bone cysts, are fluid-filled cavities within bone that typically occur in the long bones of children ages 4-10. They enlarge during growth but become inactive after skeletal maturity. Active cysts develop near the growth plate and can cause pathologic fractures. Treatment involves curettage to remove the cyst lining and bone grafting to prevent fractures and reduce the risk of recurrence.
Ewing’s sarcoma & Simple bone cyst
This document discusses two bone conditions: Ewing's sarcoma and simple bone cyst. Ewing's sarcoma is a cancerous tumor most common in children and adolescents that typically presents with pain and swelling in the long bones or axial skeleton. It is diagnosed through imaging like MRI, CT, bone scan and PET scan. Treatment involves chemotherapy, radiation therapy and surgical resection. Simple bone cyst is a benign bone lesion most common in teenagers that appears as a lytic lesion on x-ray, usually in the long bones. It is typically asymptomatic but can cause pain or fracture. Treatment options include curettage, bone grafting, or injections to promote healing.
Recommended
Volume 9
The document provides details on several cases of bone cysts, including unicameral bone cysts and aneurysmal bone cysts. It describes the typical presentation, characteristics, treatment approaches, and outcomes for each type of cyst. Radiographic images and histological photomicrographs are included to illustrate features of the cysts.
Ortho Patho Meet on Aneurysmal Bone Cyst by Dr. Saumya Agarwal
Ortho Patho Meet on Aneurysmal Bone Cyst by Dr. Saumya AgarwalCentral Institute of Orthopaedics, Safdarjang Hospital and VMMC, New Delhi
A 13-year-old female presented with a 6 month history of pain and swelling in her right thigh. On examination, a solitary 6x8 cm swelling was observed on the medial aspect of the right thigh. Imaging revealed an expansile osteolytic lesion in the femur diaphysis. Differential diagnoses included unicameral bone cyst, aneurysmal bone cyst, and telangiectatic osteosarcoma. Histopathology of a biopsy was consistent with aneurysmal bone cyst, which are benign, expansile lesions composed of blood filled spaces most commonly seen in children and adolescents. Surgical curettage and bone grafting is the traditional treatment, with a recurrence rate of around 20%.Giant cell tumour &Aneurysmal bone cyst
1. Giant cell tumour is a common benign bone tumour that typically affects people aged 20-50. It most commonly occurs around the knee and wrist in a solitary, eccentric lesion without sclerosis or well-defined margins.
2. Aneurysmal bone cyst usually affects children and adolescents under 20 and can occur throughout the body, including the long bones, spine and sacrum. It presents as a well-defined, expansile lytic lesion with thin sclerotic margins and may contain fluid-fluid levels.
3. The treatments for both tumours include curettage, but aneurysmal bone cyst may also be treated with embolisation or fibrosing agents while giant cell tumour can sometimes be treated
Simple bone cyst
Simple bone cysts, also known as unicameral bone cysts, are benign bone lesions of unknown cause that typically occur in the metaphysis of long bones like the proximal humerus and femur in children and adolescents. They appear on x-ray as areas of translucency in the bone and often cause pain, swelling or pathological fractures. Treatment involves curettage and bone grafting if the risk of fracture is high or steroid injections if the cyst is small with a low fracture risk.
Chondroblastoma
Chondroblastoma is a rare benign tumor that develops from cartilage germ cells, most commonly affecting the epiphysis of long bones in teenagers before growth plate closure. It appears lytic with punctate calcification on x-ray and shows clear borders and surrounding edema on MRI. Microscopically it contains islands of chondroblasts with chicken wire calcification and multinucleated giant cells. Treatment involves curettage with bone grafting, and it has a low recurrence rate with marginal excision but high recurrence with intra-capsular curettage.
Aneurysmal bone cyst
Locally destructive, blood-filled reactive lesions of bone and are not considered to be true neoplasm.
Simple bone cyst (unicameral)
Simple bone cysts, also known as unicameral bone cysts, are fluid-filled cavities within bone that typically occur in the long bones of children ages 4-10. They enlarge during growth but become inactive after skeletal maturity. Active cysts develop near the growth plate and can cause pathologic fractures. Treatment involves curettage to remove the cyst lining and bone grafting to prevent fractures and reduce the risk of recurrence.
Ewing’s sarcoma & Simple bone cyst
This document discusses two bone conditions: Ewing's sarcoma and simple bone cyst. Ewing's sarcoma is a cancerous tumor most common in children and adolescents that typically presents with pain and swelling in the long bones or axial skeleton. It is diagnosed through imaging like MRI, CT, bone scan and PET scan. Treatment involves chemotherapy, radiation therapy and surgical resection. Simple bone cyst is a benign bone lesion most common in teenagers that appears as a lytic lesion on x-ray, usually in the long bones. It is typically asymptomatic but can cause pain or fracture. Treatment options include curettage, bone grafting, or injections to promote healing.
Cystic lesions of bone
This document discusses various types of cystic bone lesions. It begins by defining what a cyst is and describing the general features of cystic lesions in bone. It then discusses four specific types of cystic bone lesions - solitary bone cyst, aneurysmal bone cyst, intraosseous ganglion cyst, and epidermoid cyst. For each type, it covers locations, pathogenesis, histology, imaging appearance, and treatment options. It also briefly mentions several conditions that can resemble cystic bone lesions. The document provides detailed information on solitary bone cysts and aneurysmal bone cysts.
ABC (dr.mahesh)
This document discusses aneurysmal bone cyst (ABC), beginning with its definition as a benign, expansile bone lesion containing blood-filled cystic cavities. It describes ABC's unknown etiology, most common locations in long bones of younger patients, and presentations of pain, swelling or fracture. Imaging findings include expansile lytic lesions on x-ray, and fluid-fluid levels on MRI. Treatment involves preoperative embolization and curettage with bone grafting. ABC's differential diagnosis and potential for recurrence after treatment are also summarized.
Enchondroma with Secondary Aneurysmal Bone Cyst
This case report describes an unusual case of an enchondroma with secondary aneurysmal bone cyst formation in the proximal femur of a 13-year-old male. Imaging showed a septated lytic lesion in the intertrochanteric region. Histology revealed lobulated cartilaginous proliferation without atypia surrounded by bone and blood-filled cystic spaces, consistent with a secondary aneurysmal bone cyst arising from the enchondroma. This is a rare occurrence, as cystic changes are not usually seen in enchondromas. The patient will need monitoring due to the higher recurrence risk of aneurysmal bone cysts compared to typical enchondromas.
Giant cell tumors of bone
Giant cell tumour of bone is a distinct neoplasm that arises from the supportive connective tissue of bone marrow. It is most commonly seen in patients aged 20-50 years old and presents as a lytic lesion in the epiphyseo-metaphyseal region of long bones, with 55% occurring around the knee. Pathology shows a vascularized network of stromal cells and multinucleated giant cells. Treatment involves intralesional curettage and bone grafting for stage 1 and 2 lesions. Stage 3 lesions require wide resection and reconstruction. Recurrence is common requiring additional surgery.
Cystic lesion of bones
This document discusses the diagnosis and radiological analysis of various cystic bone lesions. It provides details on 7 key questions to ask during radiological analysis of lytic bone lesions, including location, size, effect on bone, bone response, matrix type, cortex status, and soft tissue extension. It then summarizes the characteristics, presentation, diagnosis, and treatment of various specific cystic bone lesions such as solitary bone cyst, aneurysmal bone cyst, fibrous dysplasia, enchondroma, chondromyxoid fibroma, and others. Radiological findings, pathology, and management approaches are described for each condition.
Cystic diseases of bone
This document provides an overview of the approach to cystic bone lesions. It begins with definitions and classifications of benign and malignant cystic bone lesions. Key aspects to consider in the approach include the age of the patient, location of the lesion, characteristics of the transitional zone, presence of a matrix, status of the bone cortex, periosteal reaction, and soft tissue swelling. Specific cystic lesions discussed individually include aneurysmal bone cyst, solitary bone cyst, fibrous dysplasia, and enchondroma. Treatment approaches are also summarized for some of the lesions.
Lytic/cystic lesion of bone final
This document discusses imaging patterns of cystic bone tumors. Plain radiography is usually the initial imaging modality used. CT and MRI help further characterize lesions by assessing extraosseous extension, tumor relationships and content. Eosinophilic granuloma commonly appears lytic under 30 years of age. Enchondromas typically contain punctate calcification except in the hands/feet. Fibrous dysplasia has a ground glass appearance with no periostitis or pain unless fractured. Differential diagnoses are considered based on location, margins, expansion and other characteristics.
Osteochondroma
This document provides an overview of osteochondroma, which is a benign bone tumor characterized by a bony projection with a cartilage cap. It summarizes the definition, epidemiology, pathogenesis, clinical presentation, imaging features, complications, and risk of malignant transformation. Osteochondroma most commonly involves the long bones such as the femur and humerus during childhood. Imaging plays an important role in the diagnosis and surveillance for complications or malignant degeneration.
Aneurysmal Bone Cyst
An aneurysmal bone cyst is a benign bone tumor characterized by blood-filled cavities separated by bone or fibrous tissue. It most commonly affects long bones in people under 30 years old. This case report describes a rare aneurysmal bone cyst located in the cervical spine of a 13-year-old girl who presented with neck pain. Imaging showed an osteolytic lesion of the C2 spinous process. The cyst was surgically excised and pathology confirmed the diagnosis. Following halo cast immobilization, the girl recovered with no recurrence at her 2-year follow-up.
Giant cell bone
This document provides an overview of giant cell lesions of bone, including giant cell tumor, giant cell-reparative granuloma, brown tumor, aneurysmal bone cyst, and chondroblastoma. It describes the characteristic clinical features, radiographic appearance, gross pathology, histopathology, and immunohistochemical profiles of each lesion. Key distinguishing features are emphasized, such as the typical locations, sizes and appearances on imaging and grossly. The document highlights the importance of integrating clinical, radiological and pathological findings for accurate diagnosis of these lesions given overlaps in their features.
Osteochondroma
A 19-year-old male presented with a swelling on his left shoulder that had grown slowly over 5 years. X-rays and MRI identified an osteochondroma. The benign bone tumor was surgically excised to confirm the diagnosis and prevent complications. Histopathology of the removed tissue was consistent with osteochondroma. Osteochondromas are common benign bone tumors that form when pieces of growing bone break through the periosteum.
Chondroblastoma
Chondroblastoma is a benign bone tumor caused by rapid division of chondroblast cells in long bone epiphyses. It most commonly affects males in their second decade of life. While the cause is idiopathic, chromosomal abnormalities on chromosomes 5 and 6 have been associated. Clinically, patients experience pain, swelling and limping. Imaging shows a well-defined lytic lesion near the bone cortex, often with surrounding sclerosis or mottled appearance from calcification. Treatment involves surgical curettage and bone grafting for small lesions or excision for large lesions.
Bone tumour , enchondroma , osteochondroma
The document provides information on neoplasia and the differences between benign and malignant tumors. It discusses the classification, clinical presentation, investigations, and radiographic evaluation of bone tumors. Some key points include:
- Benign tumors are usually encapsulated, compress surrounding tissue, and have low growth rates, while malignant tumors are poorly circumscribed, invade tissue, and have rapid growth rates.
- Bone tumors are classified based on the WHO system, site of origin, and Enneking's staging which considers grade, tumor size, and metastasis.
- Common presentations are pain, localized swelling, and laboratory findings such as elevated alkaline phosphatase. Imaging like x-rays help identify tumor location, borders, bone destruction
Synovial chondromatosis
Synovial chondromatosis is a rare condition where cartilage develops in the synovial membrane, causing loose bodies to form in the joint. It most commonly affects large joints like the knee. While the cause is unknown, growth factors may promote cartilage formation. Patients experience pain, stiffness, swelling and decreased range of motion. Diagnosis involves x-ray, MRI or arthroscopy to view the loose bodies. Treatment is arthroscopic removal of the loose bodies with limited synovectomy for relief of symptoms. Prognosis is generally good with low risk of recurrence after surgery.
Unicameral bone cysts
Unicameral Bone Cysts are fluid-filled bone lesions most common in children under 20. They form due to venous occlusion in the bone marrow and contain substances that cause bone resorption. Clinically, they present as swelling and pain after trauma in the femur or humerus. Radiographs show expanded thin bone with fractures. Treatment involves injections or surgery to curette the cyst membrane and fill the cavity to prevent fractures and recurrence.
Presentation1.pptx, radiological imaging of rediolucent lesions of bones.
This document provides information on radiolucent bone lesions, including giant cell tumor of bone (GCT), aneurysmal bone cyst (ABC), unicameral bone cyst (UBC), eosinophilic granuloma (EG), and non-ossifying fibroma (NOF). It describes the clinical features, locations, radiographic findings, and imaging appearances of each condition. Key radiographic findings include lytic and expansile lesions with thin or thick sclerotic rims and internal trabeculations. MRI is useful for evaluating soft tissue extension and detecting fluid-fluid levels in ABC.
Osteosarcoma
Osteosarcoma is a malignant bone tumor characterized by the production of osteoid bone. It is the second most common primary bone malignancy and occurs most often in the metaphysis of long bones in adolescents and young adults. The tumor may be conventional, presenting as osteoblastic, chondroblastic or fibroblastic subtypes, or may be a rare telangiectatic or well-differentiated variant. While the exact cause is unknown, risk factors include rapid bone growth, genetic conditions, radiation exposure and pre-existing bone diseases.
191105 osteochondroma and hme
Osteochondromas are benign bone tumors that form on the external surface of bones. They originate from within the periosteum as small cartilage-capped bony projections that grow in proportion with the patient during development. Most commonly found in the metaphysis of long bones, osteochondromas can cause pressure symptoms but usually cause no issues. Multiple hereditary exostoses is a genetic condition where multiple osteochondromas form due to mutations in EXT1/EXT2 genes. While generally benign, osteochondromas rarely develop into cartilage sarcoma with advanced age or large size. Surgical removal is indicated when they become symptomatic or suspicious for malignancy.
Fracture osteochondroma
A 14-year-old boy presented with right thigh pain after a fall. X-rays revealed a fracture through the stalk of a pedunculated osteochondroma in his right thigh. The fractured fragment was surgically excised. Histopathological examination found the excised fragment to be a cartilage capped bony projection, consistent with an osteochondroma. Osteochondromas are benign bone tumors that can rarely transform into cancers like osteosarcoma or chondrosarcoma. Surgical excision is usually recommended for symptomatic osteochondromas or those with complications like fractures.
Osteosarcoma (1)
Highly malignant tumor of mesenchymal origin.Spindle shaped cells that produce osteoid.2nd most common primary malignant bone tumor after MM.Incidence – 1 to 3 per million per year
Treated by chemo,amputation or rotationplasty
Simple bone cyst
A 24-year old female presented with pain in the right hip joint after a fall. MRI revealed a lesion in the right femur involving the subcapitate, neck, interochanteric and proximal shaft regions. The lesion was centrally located, lobulated in contour with a narrow transition zone, primarily involving the medullary cavity with associated cortical thinning. A cortical break was seen along the medial aspect of the proximal femoral shaft. Features were consistent with a simple bone cyst with fracture.
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Cystic lesions of bone
This document discusses various types of cystic bone lesions. It begins by defining what a cyst is and describing the general features of cystic lesions in bone. It then discusses four specific types of cystic bone lesions - solitary bone cyst, aneurysmal bone cyst, intraosseous ganglion cyst, and epidermoid cyst. For each type, it covers locations, pathogenesis, histology, imaging appearance, and treatment options. It also briefly mentions several conditions that can resemble cystic bone lesions. The document provides detailed information on solitary bone cysts and aneurysmal bone cysts.
ABC (dr.mahesh)
This document discusses aneurysmal bone cyst (ABC), beginning with its definition as a benign, expansile bone lesion containing blood-filled cystic cavities. It describes ABC's unknown etiology, most common locations in long bones of younger patients, and presentations of pain, swelling or fracture. Imaging findings include expansile lytic lesions on x-ray, and fluid-fluid levels on MRI. Treatment involves preoperative embolization and curettage with bone grafting. ABC's differential diagnosis and potential for recurrence after treatment are also summarized.
Enchondroma with Secondary Aneurysmal Bone Cyst
This case report describes an unusual case of an enchondroma with secondary aneurysmal bone cyst formation in the proximal femur of a 13-year-old male. Imaging showed a septated lytic lesion in the intertrochanteric region. Histology revealed lobulated cartilaginous proliferation without atypia surrounded by bone and blood-filled cystic spaces, consistent with a secondary aneurysmal bone cyst arising from the enchondroma. This is a rare occurrence, as cystic changes are not usually seen in enchondromas. The patient will need monitoring due to the higher recurrence risk of aneurysmal bone cysts compared to typical enchondromas.
Giant cell tumors of bone
Giant cell tumour of bone is a distinct neoplasm that arises from the supportive connective tissue of bone marrow. It is most commonly seen in patients aged 20-50 years old and presents as a lytic lesion in the epiphyseo-metaphyseal region of long bones, with 55% occurring around the knee. Pathology shows a vascularized network of stromal cells and multinucleated giant cells. Treatment involves intralesional curettage and bone grafting for stage 1 and 2 lesions. Stage 3 lesions require wide resection and reconstruction. Recurrence is common requiring additional surgery.
Cystic lesion of bones
This document discusses the diagnosis and radiological analysis of various cystic bone lesions. It provides details on 7 key questions to ask during radiological analysis of lytic bone lesions, including location, size, effect on bone, bone response, matrix type, cortex status, and soft tissue extension. It then summarizes the characteristics, presentation, diagnosis, and treatment of various specific cystic bone lesions such as solitary bone cyst, aneurysmal bone cyst, fibrous dysplasia, enchondroma, chondromyxoid fibroma, and others. Radiological findings, pathology, and management approaches are described for each condition.
Cystic diseases of bone
This document provides an overview of the approach to cystic bone lesions. It begins with definitions and classifications of benign and malignant cystic bone lesions. Key aspects to consider in the approach include the age of the patient, location of the lesion, characteristics of the transitional zone, presence of a matrix, status of the bone cortex, periosteal reaction, and soft tissue swelling. Specific cystic lesions discussed individually include aneurysmal bone cyst, solitary bone cyst, fibrous dysplasia, and enchondroma. Treatment approaches are also summarized for some of the lesions.
Lytic/cystic lesion of bone final
This document discusses imaging patterns of cystic bone tumors. Plain radiography is usually the initial imaging modality used. CT and MRI help further characterize lesions by assessing extraosseous extension, tumor relationships and content. Eosinophilic granuloma commonly appears lytic under 30 years of age. Enchondromas typically contain punctate calcification except in the hands/feet. Fibrous dysplasia has a ground glass appearance with no periostitis or pain unless fractured. Differential diagnoses are considered based on location, margins, expansion and other characteristics.
Osteochondroma
This document provides an overview of osteochondroma, which is a benign bone tumor characterized by a bony projection with a cartilage cap. It summarizes the definition, epidemiology, pathogenesis, clinical presentation, imaging features, complications, and risk of malignant transformation. Osteochondroma most commonly involves the long bones such as the femur and humerus during childhood. Imaging plays an important role in the diagnosis and surveillance for complications or malignant degeneration.
Aneurysmal Bone Cyst
An aneurysmal bone cyst is a benign bone tumor characterized by blood-filled cavities separated by bone or fibrous tissue. It most commonly affects long bones in people under 30 years old. This case report describes a rare aneurysmal bone cyst located in the cervical spine of a 13-year-old girl who presented with neck pain. Imaging showed an osteolytic lesion of the C2 spinous process. The cyst was surgically excised and pathology confirmed the diagnosis. Following halo cast immobilization, the girl recovered with no recurrence at her 2-year follow-up.
Giant cell bone
This document provides an overview of giant cell lesions of bone, including giant cell tumor, giant cell-reparative granuloma, brown tumor, aneurysmal bone cyst, and chondroblastoma. It describes the characteristic clinical features, radiographic appearance, gross pathology, histopathology, and immunohistochemical profiles of each lesion. Key distinguishing features are emphasized, such as the typical locations, sizes and appearances on imaging and grossly. The document highlights the importance of integrating clinical, radiological and pathological findings for accurate diagnosis of these lesions given overlaps in their features.
Osteochondroma
A 19-year-old male presented with a swelling on his left shoulder that had grown slowly over 5 years. X-rays and MRI identified an osteochondroma. The benign bone tumor was surgically excised to confirm the diagnosis and prevent complications. Histopathology of the removed tissue was consistent with osteochondroma. Osteochondromas are common benign bone tumors that form when pieces of growing bone break through the periosteum.
Chondroblastoma
Chondroblastoma is a benign bone tumor caused by rapid division of chondroblast cells in long bone epiphyses. It most commonly affects males in their second decade of life. While the cause is idiopathic, chromosomal abnormalities on chromosomes 5 and 6 have been associated. Clinically, patients experience pain, swelling and limping. Imaging shows a well-defined lytic lesion near the bone cortex, often with surrounding sclerosis or mottled appearance from calcification. Treatment involves surgical curettage and bone grafting for small lesions or excision for large lesions.
Bone tumour , enchondroma , osteochondroma
The document provides information on neoplasia and the differences between benign and malignant tumors. It discusses the classification, clinical presentation, investigations, and radiographic evaluation of bone tumors. Some key points include:
- Benign tumors are usually encapsulated, compress surrounding tissue, and have low growth rates, while malignant tumors are poorly circumscribed, invade tissue, and have rapid growth rates.
- Bone tumors are classified based on the WHO system, site of origin, and Enneking's staging which considers grade, tumor size, and metastasis.
- Common presentations are pain, localized swelling, and laboratory findings such as elevated alkaline phosphatase. Imaging like x-rays help identify tumor location, borders, bone destruction
Synovial chondromatosis
Synovial chondromatosis is a rare condition where cartilage develops in the synovial membrane, causing loose bodies to form in the joint. It most commonly affects large joints like the knee. While the cause is unknown, growth factors may promote cartilage formation. Patients experience pain, stiffness, swelling and decreased range of motion. Diagnosis involves x-ray, MRI or arthroscopy to view the loose bodies. Treatment is arthroscopic removal of the loose bodies with limited synovectomy for relief of symptoms. Prognosis is generally good with low risk of recurrence after surgery.
Unicameral bone cysts
Unicameral Bone Cysts are fluid-filled bone lesions most common in children under 20. They form due to venous occlusion in the bone marrow and contain substances that cause bone resorption. Clinically, they present as swelling and pain after trauma in the femur or humerus. Radiographs show expanded thin bone with fractures. Treatment involves injections or surgery to curette the cyst membrane and fill the cavity to prevent fractures and recurrence.
Presentation1.pptx, radiological imaging of rediolucent lesions of bones.
This document provides information on radiolucent bone lesions, including giant cell tumor of bone (GCT), aneurysmal bone cyst (ABC), unicameral bone cyst (UBC), eosinophilic granuloma (EG), and non-ossifying fibroma (NOF). It describes the clinical features, locations, radiographic findings, and imaging appearances of each condition. Key radiographic findings include lytic and expansile lesions with thin or thick sclerotic rims and internal trabeculations. MRI is useful for evaluating soft tissue extension and detecting fluid-fluid levels in ABC.
Osteosarcoma
Osteosarcoma is a malignant bone tumor characterized by the production of osteoid bone. It is the second most common primary bone malignancy and occurs most often in the metaphysis of long bones in adolescents and young adults. The tumor may be conventional, presenting as osteoblastic, chondroblastic or fibroblastic subtypes, or may be a rare telangiectatic or well-differentiated variant. While the exact cause is unknown, risk factors include rapid bone growth, genetic conditions, radiation exposure and pre-existing bone diseases.
191105 osteochondroma and hme
Osteochondromas are benign bone tumors that form on the external surface of bones. They originate from within the periosteum as small cartilage-capped bony projections that grow in proportion with the patient during development. Most commonly found in the metaphysis of long bones, osteochondromas can cause pressure symptoms but usually cause no issues. Multiple hereditary exostoses is a genetic condition where multiple osteochondromas form due to mutations in EXT1/EXT2 genes. While generally benign, osteochondromas rarely develop into cartilage sarcoma with advanced age or large size. Surgical removal is indicated when they become symptomatic or suspicious for malignancy.
Fracture osteochondroma
A 14-year-old boy presented with right thigh pain after a fall. X-rays revealed a fracture through the stalk of a pedunculated osteochondroma in his right thigh. The fractured fragment was surgically excised. Histopathological examination found the excised fragment to be a cartilage capped bony projection, consistent with an osteochondroma. Osteochondromas are benign bone tumors that can rarely transform into cancers like osteosarcoma or chondrosarcoma. Surgical excision is usually recommended for symptomatic osteochondromas or those with complications like fractures.
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Presentation1.pptx, radiological imaging of rediolucent lesions of bones.
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Osteosarcoma (1)
Highly malignant tumor of mesenchymal origin.Spindle shaped cells that produce osteoid.2nd most common primary malignant bone tumor after MM.Incidence – 1 to 3 per million per year
Treated by chemo,amputation or rotationplasty
Simple bone cyst
A 24-year old female presented with pain in the right hip joint after a fall. MRI revealed a lesion in the right femur involving the subcapitate, neck, interochanteric and proximal shaft regions. The lesion was centrally located, lobulated in contour with a narrow transition zone, primarily involving the medullary cavity with associated cortical thinning. A cortical break was seen along the medial aspect of the proximal femoral shaft. Features were consistent with a simple bone cyst with fracture.
Giant aneurysmal bone cyst - البروفيسور فريح ابوحسان - اكياس العظام العملاقه
Giant aneurysmal bone cyst - البروفيسور فريح ابوحسان - اكياس العظام العملاقهProf Freih Abu Hassan البروفيسور فريح ابوحسان
جراحة العظام / علاج العظام في الاردن / افضل دكتور عظام في الاردن / افضل اخصائي عظام في الاردن / استشاري عظام/افضل استشاري عظام في الاردن /جراحة عظام / /عمليات تطويل العظام في الاردن / اطباء العظام في الاردن / دكتور طب عظام في الاردن / الاطباء في الاردن / خلع ورك / عمليات اليزاروف في الاردن /علاج الكسور /خلع الولادة / تركيب المفصل / اوجاع العظام /افضل طبيب عظام اطفال في الاردن / استشاري اطفال عظام في الاردن / /علاج خلع الكتف / علاج التواء الكاحل / التواء الكاحل / علاج الام العظام / علاج هشاشة العظام / ارقام اطباء عظام في الاردن / مشاكل العظام والمفاصل /مستشار جراحة العظام والمفاصل والكسور/مستشار جراحة عظام الأطفال.GCT of bone presentation by prof.Ahmad shaheen,M.D. prof.of orthopedic surger...
GCT is one of the most common benign bone tumors,characterized by high incidence of local recurrence.
the pathogenesis,pathology,clinical presentation and treatment options will be discussed.
Giant cell tumor
This document discusses various giant cell lesions including giant cell tumor, osteoclastoma, and other lesions such as chondroblastoma, Brow tumor of hyperparathyroidism, reparative giant cell granuloma, aneurysmal bone cyst (ABC), simple bone cyst, and non-ossifying fibroma.
Giant Cell Tumors of Bones: Management & Single Author Experience
This document discusses giant cell tumor of bone (GCTB) and the potential role of denosumab in its management. It provides background information on GCTB, including its incidence, presentation, histopathology involving RANKL expression, and standard treatment options. It then describes a pilot study of 17 patients with advanced or metastatic GCTB who were treated with denosumab. The majority of patients experienced pain alleviation and stabilization or improvement of neurological deficits and pulmonary metastases. Denosumab represents a promising targeted therapy for salvage treatment of difficult GCTB cases.
Giant
Giant cell tumor of bone is a benign but aggressive tumor comprising 5% of bone tumors. It typically occurs in the long bones of the lower extremity in 20-40 year olds. Diagnosis is made based on imaging showing an eccentric, osteolytic lesion extending into the subchondral bone. Treatment involves curettage with phenolization or cryosurgery to minimize the high recurrence rate of 40-60%.
Giant cell tumour And Osteosarcoma
This document discusses giant cell tumour and osteosarcoma. Giant cell tumour is a common bone tumour that occurs in ages 20-40 and affects bones around the knee and lower radius. It appears lytic on x-ray with soap bubble appearance. Treatment involves excision or curettage with reconstruction. Osteosarcoma is a highly malignant bone tumour that occurs in ages 15-25 and affects ends of long bones. It presents with pain, swelling and pathological fracture. Treatment requires confirmation with biopsy, evaluation of spread, and surgical ablation with chemotherapy to control metastases. Prognosis is poor without treatment but improved with surgery and chemotherapy.
Gct of distal radius
1. The document discusses treatment options for giant cell tumor of the distal radius, including extended curettage with adjuvant therapies like phenol or bone cement for lower grade tumors, and en bloc resection with reconstruction using osteochondral allograft or arthrodesis for higher grade tumors.
2. Studies have found that extended curettage with cement has a high local control rate and good functional outcomes compared to wide resection.
3. Reconstruction options after tumor resection include osteoarticular allograft, vascularized fibular graft, or arthrodesis depending on the extent of bone loss and need to preserve wrist or forearm function.
Vol 10 ppt
This document discusses giant cell tumor of bone (GCT), a benign bone tumor typically seen in young adults. It most commonly occurs in the ends of long bones near joints like the knee. The tumor is lytic and geographic on x-ray. Treatment typically involves aggressive curettage followed by packing the defect with bone graft or cement, with a 5-10% recurrence rate. Even though considered benign, 1-2% of GCTs can metastasize to the lungs. Radiation can increase risk of malignant transformation. Several case examples are presented demonstrating features, treatment approaches, and outcomes of GCT in various bone locations.
Brachial plexus
The brachial plexus is formed by the ventral rami of spinal nerves C5-T1, which supply the upper limb. It is a network of nerves that branches out to form the five main nerves of the arm - the median, ulnar, radial, musculocutaneous and axillary nerves. Injuries to different parts of the brachial plexus cause weakness and sensory loss in specific areas innervated by the affected nerves. Erb's palsy is a type of brachial plexus birth injury that results in weakness of shoulder and arm muscles on the affected side.
"GIANT CELL TUMOR" : CASE PRESENTATION- At Shaheed Suhrawardy Medical College...
"GIANT CELL TUMOR" : CASE PRESENTATION- At Shaheed Suhrawardy Medical College...Shaheed Suhrawardy Medical College
"GIANT CELL TUMOR" : CASE PRESENTATION- At Shaheed Suhrawardy Medical College Hospital, Dhaka, BangladeshGiant cell tumour of bone
Giant Cell Tumor of Bone is a benign but locally aggressive bone tumor comprising 5% of all bone tumors. It typically occurs in long bones near the knee in adults aged 20-40. Imaging shows an eccentric lytic lesion in the epiphysis or metaphysis. Treatment involves intralesional curettage with adjuvant therapies like phenol or PMMA cementing to reduce the high recurrence risk of 60% with curettage alone. Wide resection can control the tumor but risks complications from reconstruction. Recurrence usually occurs within 2 years and is treated with repeat curettage.
Suprascapular Nerve Palsy - Lennard Funk 2015
The suprascapular nerve provides motor innervation to the supraspinatus and infraspinatus muscles. It has sensory branches innervating structures around the shoulder joint. Suprascapular nerve palsy can result from compression at the suprascapular or spinoglenoid notches, causing weakness and wasting of the supraspinatus and infraspinatus. MRI and EMG are used to identify any ganglion cysts or lesions compressing the nerve. Small cysts may resolve on their own, while larger cysts or failure to improve may require arthroscopic decompression of the suprascapular notch to release compression of the nerve. Proper surgical technique is important to address any associated pathology
Osteonecrosis of the femoral head
This document discusses osteonecrosis of the femoral head, including risk factors, pathogenesis theories, classifications, diagnosis, and treatment options. Key points:
- Risk factors include corticosteroid use, smoking, sickle cell anemia and others. Theories on causes include toxicity, vascular issues, but the process is likely multifactorial.
- Diagnosis involves radiographs, bone scans and MRI, which can detect early-stage disease.
- Treatment depends on disease stage and size. Options include core decompression, bone grafting, osteotomies and arthroplasty. Younger patients with smaller lesions may be candidates for bone-preserving options, while larger lesions often require joint replacement.
Brachaial Plexus Injury
The document discusses brachial plexus injuries, which involve damage to the network of nerves between the neck and arm. It describes the anatomy of the brachial plexus and its branches. There are two main types of brachial plexus injuries - Erb's palsy, which involves the upper trunk and results in weakness of shoulder and arm muscles, and Klumpke's palsy, which involves the lower trunk and causes hand deformities. Causes include difficult childbirth and other stretching or trauma to the neck and shoulders. Management involves medical treatment of pain as well as potential surgical interventions and physical therapy.
Osteosarcoma: A Detailed Review
It is a presentation covering all the important aspects of the 2nd most common tumor, osteosarcoma in extensive details.
Giant cell tumor
This document provides an overview of giant cell tumor, a type of benign bone tumor. It discusses the definition, epidemiology, clinical presentation, investigations, grading, differential diagnosis, and treatment options. Giant cell tumor commonly involves the ends of long bones and is locally aggressive, destroying bone tissue. While benign, it can occasionally metastasize. Treatment typically involves curettage with the use of adjuvants like phenol or bone cement to reduce the high risk of recurrence. Reconstruction of residual defects is often done with bone grafts or cement.
Avascular Necrosis of the Femoral Head
This document discusses avascular necrosis of the femoral head, also known as osteonecrosis. It begins by providing a brief history and definitions. It then discusses the blood supply of the femoral head and covers traumatic vs. non-traumatic causes. Risk factors for atraumatic osteonecrosis like corticosteroids, alcohol abuse, smoking, and others are outlined. The pathophysiology section explores theories of arterial occlusion, fat emboli, and increased bone marrow pressure as causes. Signs and symptoms, diagnostic imaging methods, staging classifications, and non-operative and operative treatment options are summarized.
Thoracolumbar fractures
This document provides an overview of thoracolumbar fractures, including epidemiology, clinical evaluation, classification systems, radiographic evaluation, treatment approaches, and specific surgical techniques. It discusses the anatomy of the thoracolumbar region, mechanisms of injury, neurological assessment tools, radiographic indicators of instability, and non-operative and operative treatment options depending on the fracture classification.
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Giant aneurysmal bone cyst - البروفيسور فريح ابوحسان - اكياس العظام العملاقه
Giant aneurysmal bone cyst - البروفيسور فريح ابوحسان - اكياس العظام العملاقه
GCT of bone presentation by prof.Ahmad shaheen,M.D. prof.of orthopedic surger...
GCT of bone presentation by prof.Ahmad shaheen,M.D. prof.of orthopedic surger...
Giant Cell Tumors of Bones: Management & Single Author Experience
Giant Cell Tumors of Bones: Management & Single Author Experience
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"GIANT CELL TUMOR" : CASE PRESENTATION- At Shaheed Suhrawardy Medical College...
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Bone tumours
The document discusses classification and staging of bone tumors. Enneking's surgical staging system classifies bone tumors based on their histological grade, location within the bone, and presence of metastases. The stages range from 1 to 3, with higher numbers indicating more advanced or aggressive tumors. Several benign and malignant bone tumors are also described in terms of their typical location, patient demographics, clinical and radiological appearance, pathology, treatment options, and prognosis.
Benign bone tumors
This document summarizes various benign bone tumors classified by the WHO. It describes the clinical features, radiographic appearance, histology, and treatment for common benign bone tumors including osteoid osteoma, osteoblastoma, enchondroma, osteochondroma, chondroblastoma, fibrous dysplasia, giant cell tumor, chondromyxoid fibroma, simple bone cyst, aneurysmal bone cyst, and osseous hemangioma. These tumors typically present with pain, swelling, or pathological fracture and are diagnosed radiographically with confirmation by biopsy. Treatment involves surgical excision, curettage, or observation depending on the tumor type and characteristics.
AVASCULAR NECROSIS
This document discusses avascular necrosis (AVN), also known as osteonecrosis. It begins by defining AVN as the death of bone components due to interrupted blood supply. Key areas that are commonly affected are described. The document then covers the pathophysiology, various causes (traumatic, non-traumatic), clinical presentation, imaging techniques, staging classifications, and management strategies for AVN. Treatment approaches include conservative options, decompression procedures, realignment osteotomies, arthrodesis, and arthroplasty.
Osteosarcoma (knee joint)
This is a powerpoint(case presentation) for radiology and imaging resident.There are many animations used inside this presentation so to see all the pictures which are placed layer by layer with the help of animations you simple need to download this presentation first.... Thanx.
Ewing's Sarcoma.pptx
Ewing sarcoma is the second most common malignant bone tumor in children. It occurs most commonly in patients between 5-25 years old. Diagnosis involves imaging like MRI and CT to identify bone destruction and soft tissue involvement. Pathology shows small, blue, round cells. Treatment involves induction chemotherapy followed by surgery or radiation if possible to achieve wide resection margins, with additional maintenance chemotherapy to reduce risk of metastasis, most commonly to lungs and bones. Prognosis depends on ability to achieve wide surgical resection and response to chemotherapy. Five-year survival has improved to over 70% with current multimodal treatment approaches.
Malignant bone tumours
Radiological approach to malignant bone tumours,
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Malignant bone tumours recall
metastatic-bone-tumor.ppt
Metastatic bone tumors are most commonly caused by cancer spreading from another primary site to the bones. Approximately 50% of cancers can metastasize to the skeleton, with the most common sites being the vertebrae, pelvis, femur, ribs, humerus and skull. The presentation may include bone pain, pathologic fractures, masses, or neurological impairment. Diagnosis involves history, physical exam, imaging like x-rays, CT, MRI and bone scans. Treatment depends on cancer type but often includes radiation, chemotherapy, hormone therapy, surgery and bisphosphonates. Local therapies aim to destroy cancer cells at the specific bone site while systemic therapies target cells throughout the body.
Pagests disease,eosinophilic granuloma,heterotopic ossification
1) The document reviews Paget's disease of bone, discussing its epidemiology, pathophysiology, clinical presentation, diagnosis, and management. It affects bone remodeling and can cause pain, deformity, fractures, and neurological complications.
2) Treatment may involve medications like calcitonin and bisphosphonates to reduce symptoms and prevent complications. Surgery is occasionally needed for deformity correction or joint replacement, with careful attention to bleeding risks.
3) Complications of Paget's disease include arthritis, fractures, neurological problems, and rare malignant transformation. Management involves a multidisciplinary approach with medications, surgery, and lifestyle modifications.
Osteosarcoma
1. Osteosarcoma is a malignant bone tumor derived from primitive mesenchymal cells. It most commonly occurs in the metaphysis of long bones in children and young adults.
2. Conventional intramedullary osteosarcoma is the most common subtype. It is an aggressive tumor characterized by the production of osteoid matrix. Treatment involves neoadjuvant chemotherapy, surgical resection with wide margins, and adjuvant chemotherapy.
3. Other subtypes include telangiectatic, surface/juxtacortical, and intracortical osteosarcomas, which have varying presentations, imaging characteristics, histology, and clinical behaviors. Accurate diagnosis and subtyping is important for
GIANT CELL TUMOR.pptx
This document summarizes giant cell tumor (GCT), a type of bone tumor. It describes how GCT was first described in 1818 and characterized in detail in 1940. It affects skeletally mature patients, more commonly females than males. Histologically, it contains giant cells and stromal cells. Treatment options include curettage with or without adjuvants like phenol or cryotherapy to reduce the high recurrence rate of simple curettage. Extended curettage techniques along with bone cement are commonly used to reconstruct the defect following tumor removal.
TUBERCULOSIS OF SPINE.pptx
Hello students.
It's a lecture prepared from maheshwari with pictures attached. This is sufficient for for answering a question in examination at mbbs level.
A case chronic ostyeomyelitis
A 17-year-old male presented with pain in his right thigh for one month and fever for four days. He had a history of minor trauma to the right thigh one month prior. Examination found swelling and tenderness in the right mid-thigh. Imaging showed an abscess and osteomyelitis of the right femur. Biopsy revealed chronic osteomyelitis. He was treated with antibiotics and surgery to drain the abscess. Further imaging showed increased periosteal reaction concerning for Ewing's sarcoma. Additional treatment was planned including reaming of the femur and repeat biopsy.
Bone Tumor And Tumor Like Diseases
1. The document discusses the classification, diagnosis, and imaging appearances of various bone tumors and tumor-like lesions.
2. Key bone tumors discussed include osteosarcoma, giant cell tumor, and bone cyst. Osteosarcoma is classified based on X-ray signs into osteosclerotic, osteolytic, or mixed types.
3. Imaging findings help determine if a bone lesion is benign or malignant based on characteristics such as boundaries, destruction pattern, periosteal reaction, and surrounding soft tissues.
Introduction skeletal radiology(11月20.)
This document provides an overview of musculoskeletal radiology and imaging techniques used to evaluate the musculoskeletal system. It discusses normal skeletal anatomy and appearances on x-rays. Common radiological signs are described, such as osteoporosis, fractures, and periosteal reactions. Imaging findings of musculoskeletal disorders like osteomyelitis and tumors are also reviewed. Evaluation of fractures and dislocations with different imaging modalities is covered.
Principles of management of malignant bone tumours
This document outlines principles for managing malignant bone diseases. It discusses common primary bone tumors like osteosarcoma and metastases to bone from other cancers like breast and prostate. Diagnosis involves history, physical exam, imaging like x-rays and biopsy. Staging uses systems like Enneking and TNM. Treatment is usually multidisciplinary and may involve neoadjuvant chemotherapy, surgical resection with the goal of tumor-free margins, reconstruction of defects, and adjuvant therapies. Limb salvage surgeries aim to preserve function while achieving clear margins, though amputation may be needed in some cases. Prognosis depends on tumor type, stage, and response to treatment.
Extraskeletal Mesenchymal Chondrosarcoma
This document discusses two types of soft tissue sarcomas: mesenchymal chondrosarcoma and synovial sarcoma. Both tumor types contain soft tissue components, calcified areas, mineralization, and cystic areas or necrosis/hemorrhage. Mesenchymal chondrosarcoma has a bimodal age distribution in the 3rd and 5th decades, while synovial sarcoma typically presents between 15-50 years of age, with a mean of 35 years. The tumors can arise in soft tissues near joints. Imaging findings include soft tissue masses with mineralization or calcification that demonstrate enhancement. Histopathological examination is needed for definitive diagnosis of each tumor type.
Bone mets video
Bone metastases occur when cancer spreads from its original site to the bone. Common primary sites are the lung, breast, prostate, and kidney. Symptoms include pain, possible fracture or nerve compression, and elevated calcium levels. Common sites of bone metastases are the spine, ribs, pelvis, and femurs. Bone metastases are typically lytic (creating holes) or blastic (creating abnormal white areas). Radiation therapy is effective in relieving symptoms for most patients and pain response is achieved in 58% of patients undergoing reirradiation for recurrent bone metastases.
Osteosarcoma
The document describes a case of a 32-year-old male who presented with pain and swelling in his right ankle for 1 year and 6 months respectively. On examination, tenderness was found around the swelling. X-ray showed a mixed lytic and sclerotic lesion in the talus with periosteal reaction and soft tissue swelling. Differential diagnoses of Ewing sarcoma, synovial osteosarcoma, and osteomyelitis were provided. The document then discusses the features of osteosarcoma, osteomyelitis, Ewing sarcoma, and synovial sarcoma.
Bone tumor
Bone tumors can be benign or malignant growths of bone tissue. Common sites for malignant bone tumors are the distal femur, proximal tibia, and proximal humerus. The most common and fatal malignant bone tumor is osteosarcoma, which often spreads to the lungs. Symptoms of bone tumors include localized pain in the bone, limited range of motion, weight loss, and pathologic fractures. Diagnostic tests include bone x-rays to detect the tumor and chest x-rays to check for lung metastases, with biopsy used to examine the tumor histologically. Treatment aims to destroy or remove the tumor through radiation therapy, chemotherapy, surgery such as limb-sparing procedures or amputation.
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Pagests disease,eosinophilic granuloma,heterotopic ossification
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Pediatrics 6th year, Tutorial (Dr. Tara Husain)
This document outlines guidelines for neonatal life support, including drying and warming the baby, assessing need for intervention, establishing an airway, ventilating the lungs, performing rescue breathing or chest compressions, and administering drugs if needed. It discusses delaying cord clamping, using air or blended oxygen for resuscitation, and wrapping preterm babies. Guidelines for compression to ventilation ratio, meconium suction, and therapeutic hypothermia are also presented. Steps for basic and advanced life support are outlined.
Pediatrics 6th year, Tutorial (Dr. Adnan)
Growth and development milestones from birth through age 5 are outlined. Growth refers to increases in cell mass and number, while development is the differentiation of functions. Key milestones are provided for gross and fine motor skills, communication/language, and cognitive/social development according to average ages. Growth is also defined for weight, height/length, and head circumference based on age.
Tubes, Suture Materials, IV Fluids photos
This document contains a list of various medical equipment and supplies used for anesthesia and airway management. Items on the list include different types of endotracheal tubes, laryngeal masks, tracheostomy tubes, airway devices, sutures, IV fluids, and wound closure materials. The list appears to be an inventory of available anesthesia and surgical supplies.
Surgery 6th year, Tutorial (Dr. Aram Baram)
I examined this patient's peripheral vascular system. On inspection from the end of the bed, the patient appeared comfortable at rest with no signs of vascular disease. Both limbs were pink and well perfused with normal capillary refill times. All pulses were present and equal bilaterally. Buerger's test was negative. To complete my examination, I would assess the cardiovascular system and test the relevant muscles and nerves of the affected limb, and perform duplex scans and ankle-brachial pressure indexes.
Surgery 6th year, Tutorial (Dr. Aram Baram)
This document summarizes common venous disorders, including varicose veins, superficial thrombophlebitis, deep vein thrombosis (DVT), and their causes, risk factors, symptoms, diagnosis, and treatment. Some key points:
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- DVT occurs when blood clots form in the deep veins, usually in the legs. It can cause leg swelling/pain and potentially fatal pulmonary embolism. Risk increases with age, surgery, trauma, cancer, and genetic factors. Ul
Surgery 6th year, Tutorial (Dr. Hamid)
This document summarizes the surgical management of lumbar disc herniation. It outlines the absolute and relative indications for surgery, as well as the optimal timing. The available surgical interventions are listed, along with their common complications and results. Cauda equina syndrome is the absolute indication for surgery and requires immediate treatment. Relative indications include failure of conservative treatments and severe, intractable radicular pain. Open discectomy is considered the gold standard, while microdiscectomy has shorter recovery times. Patient selection influences surgical outcomes.
Surgery 6th year, Tutorial (Dr. AbdulWahid)
The origins of surgery can be traced back many centuries, with practitioners using various materials and techniques for closing wounds. Ancient methods included using ants or thorns to close wounds. In more modern times, catgut made from sheep intestine was used. Post-World War II, sutures were developed with needles attached to reduce tissue trauma. Sutures are classified based on material and absorbability, and appropriate suture selection depends on factors like the tissue and wound characteristics.
Surgery 6th year, Tutorial (Dr. Ali A. Nabi)
The document discusses the anatomy and examination of the knee joint. It details the two knee joints - the patellofemoral and tibiofemoral joints. It describes the ligaments that provide stability to the tibiofemoral joint, including the anterior cruciate ligament and posterior cruciate ligament. The document outlines how to examine a patient's knee through obtaining a history, assessing symptoms, performing physical signs and tests of stability. Common tests mentioned include the Lachman test, McMurray's test and apprehension test. Imaging options like x-rays, MRI and arthrography are also summarized.
Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)
This document discusses hydrocephalus, including its definition, causes, classification, presentation, diagnosis and treatment. Some key points:
- Hydrocephalus is an abnormal enlargement of the ventricles due to excessive CSF accumulation from disturbances in flow, absorption or secretion.
- It can be obstructive, caused by blockages, or communicating, caused by issues outside the ventricles or with CSF absorption.
- Common causes include tumors, infections, bleeding and congenital abnormalities.
- Treatment involves surgically inserting shunts to drain CSF from the brain to the abdomen, or performing third ventriculostomies to create openings and bypass blockages.
Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Surgery 6th year, Tutorial (Dr. AbdulWahid)
Lower GI hemorrhage can originate from the colon or small bowel. Common causes include bleeding diverticulosis, colonic angiodysplasia, and neoplasms. Evaluation involves laboratory tests, colonoscopy, video capsule endoscopy, or angiography to locate the bleeding site. Treatment options depend on the cause but may include endoscopic therapies, angiographic embolization, or surgery.
Surgery 6th year, Tutorial (Dr. Bakhtyar Rasul)
Developmental dysplasia of the hip is a condition where the hip joint is unstable or partially dislocated. It affects 1-50 out of every 1000 live births, with 60% being detected by 1 week of age and 90% by 8 weeks. The document discusses the anatomy, aetiology, pathology, clinical features, imaging, and different treatment approaches depending on if the patient is under 6 months, 6 months to 6 years, or above 6 years of age.
Surgery 6th year, Tutorial (Dr. AbdulWahid)
This document summarizes the management of upper GI hemorrhage. It outlines the steps to take which include obtaining a complete history and physical exam, performing laboratory tests, considering radiological scans, stabilizing the patient, identifying the source of bleeding through endoscopy, and various pharmacological and endoscopic interventions depending on the underlying cause of bleeding such as PPIs, octreotide, angiography, embolization, surgery, or TIPS procedure. Refractory cases may require repeat endoscopy, angiography, embolization or surgery.
Surgery 6th year, Tutorial (Dr. AbdulWahid)
- Gastrointestinal hemorrhage is a common medical problem, accounting for 1-2% of hospital admissions. The most common causes are peptic ulcer disease (50%), esophageal varices (10-20%), and gastritis (10-25%).
- Symptoms depend on the location of bleeding in the GI tract. Upper GI bleeding causes vomiting blood (hematemesis) or black tarry stools (melena), while lower GI bleeding causes maroon or red blood in stool (hematochezia).
- Common etiologies include peptic ulcers, esophageal/gastric varices, gastritis, Mallory-Weiss tears, watermelon stomach, and Die
Surgery 6th year, Tutorial (Dr. AbdulWahid)
The document discusses different types of drains used in medical procedures including closed and open drains. Closed drains have lower infection rates but limit mobility while open drains are softer and more comfortable. Examples of closed drains include pigtail catheters and urinary catheters while open drains include Penrose and corrugated drains. Potential problems with all drains include tissue trauma, erosion, herniation, leaks, bacterial infection, and fluid/electrolyte loss.
Surgery 6th year, Tutorial (Dr. Ahmed Al-Azzawi)
The document discusses various artery emergencies including acute arterial occlusion, abdominal aortic aneurysm, and peripheral vascular injuries. Acute arterial occlusion occurs when blood flow to the leg is suddenly blocked, requiring immediate medical care to restore flow and prevent tissue death and gangrene. Symptoms include severe leg pain and skin changes. Abdominal aortic aneurysms are localized dilations of the abdominal aorta, often below renal arteries, and may cause abdominal or back pain. Peripheral vascular injuries from trauma can damage arteries and require rapid treatment to prevent limb loss.
Surgery 6th year, Tutorial (Dr. Sarwar Noori)
The document discusses different treatment options for renal and ureteric stones, including conservative management, extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureteroscopy (URS), and open surgery. For renal stones less than 2cm, ESWL is recommended, while PCNL may be used for larger stones or when ESWL fails. URS is recommended for ureteric stones, with an 85-90% success rate in achieving a stone-free state. Complications, prevention strategies, and dietary and medication advice are also summarized.
Surgery 6th year, Tutorial (Dr. AbdulWahid)
This document discusses fluid and electrolyte balance and management. It covers the composition of body fluids, mechanisms that regulate fluid homeostasis, and types of parenteral fluid therapy including crystalloids like saline solutions and dextrose solutions, as well as colloid solutions. It provides guidelines on fluid replacement and maintenance requirements, and examples of intravenous fluid orders.
Surgery 6th year, Tutorial (Dr. Bakhtyar Baram)
This document discusses various types of orthopedic infections including acute and subacute hematogenous osteomyelitis, chronic osteomyelitis, purulent infectious arthritis, soft tissue infections, and postoperative, posttraumatic, and postarthroplasty infections. It covers the incidence, diagnosis, and treatment of these conditions. Key factors that can influence infections include patient factors like general health, immunology, and alcohol/medicine use as well as surgical factors such as preparation, sterilization, and operating theater. Diagnosis involves clinical examination, laboratory tests, imaging like x-rays, ultrasound, CT, and MRI scans. Treatment depends on the type and severity of infection but generally involves antibiotics, biopsy or aspiration, surgery
Surgery 6th year, Tutorial (Dr. Aso Omar)
The kidneys can be injured by blunt or penetrating trauma, requiring timely medical evaluation. The kidneys are normally protected by back muscles but can be damaged by severe impacts or objects piercing the skin. Blunt trauma may cause bruising while penetrating injuries like gunshots can enter elsewhere and travel to the kidneys. Most kidney injuries are minor but evaluation with imaging tests like ultrasound or CT scans helps classify the injury and guide management, which may include rest, antibiotics, surgery, or nephrectomy in more severe cases.
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- 2. Pain Swelling Spine Metaphysis of the long bones Young adult Aneurysmal bone cyst
- 3. Pathology Cyst contains clotted blood The membrane contains giant cells
- 5. Treatment Curettage + Bone graft ( Profuse bleeding) Recurrence is common
- 7. Clinical features Young adult Pain at the end of a long bone ± Slight swelling Pathological # in%15
- 8. Imaging Eccentric radiolucent at the end of a long bone( soap bubble) Always extends to the articular cartilage CT + MRI = extent
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- 10. Primary Malignant Bone Tumours
- 13. Blood exam (1) Anaemia (2) ↑ESR (3) ↑serum alkaline phosphatase
- 14. Imaging Plain X-ray Alternating osteolytic and osteoblastic areas Margins are poorly defined The cortex is breached Codman’s triangle Sunburst effect
- 15. Radioisotope study : skip lesions CT and MRI : extent of the lesion Chest X-ray and CT of the lung : lung metastasis Diagnosis (1) Imaging (2) Biopsy: Mandatory Treatment Chemotherapy + Resection OR Amputation + Chemotherapy
- 16. Diagnosis (1) Imaging (2) Biopsy: Mandatory Treatment Chemotherapy + Resection OR Amputation + Chemotherapy
- 17. Ewings sarcoma Pathology Arises from endothelial cells in the bone marrow Clinical features 10-20 years Throbbing pain in tibia or fibula or clavicle Swelling Generalized illness Pyrexia Tenderness ↑ ESR
- 18. Imaging Middiaphysis Bone destruction Fusiform layers of bone ( onion-peel appearance)
- 19. Treatment Radiotherapy and chemotherapy have dramatic effect Amputation may be needed
- 20. Metastatic bone disease Sources Breast Prostate Kidney Lung Thyroid Bladder GIT In 10% no primary is found Commonest sites for bone metastasis Vertebrae Pelvis Proximal ½ of femur and humerus
- 21. Clinical presentations Pain Sudden backache in elderly Incidentally on Xray Pathological # Sudden collapse of a vertebral body Symptoms of hypercalcaemia( anorexia, nausea, thirst, polyuria, abdominal pain, general weakness)
- 23. Radioscintigraphy using 99mTc-HDP is the most sensitive in detecting silent metastatic deposits Special investigations (1)↑ESR (2) ↓Hb (3) ↑Serum alkaline phosphatase (4) ↑Serum acid phosphatase in prostatic Ca
- 24. Special investigations (1)↑ESR (2) ↓Hb (3) ↑Serum alkaline phosphatase (4) ↑Serum acid phosphatase in prostatic Ca
- 25. Treatment (1) Primary tumor = Accordingly (2) Fracture of the shaft = internal fixation followed by radiotherapy (3) Fracture of femoral neck = replacement followed by radiotherapy (4) Large deposit may fracture = prophylactic internal fixation (5) Stable vertebral # = brace (6)Unstable vertebral # = spinal fusion (7) Signs of cord compression = urgent decompression + stabilization (8) Terminal stage of the disease = radiotherapy ± steroid ± narcotics