Musckuloskeletal MCQsMusckuloskeletal MCQs

Aneurysmal Bone Cyst (ABC) Aneurysmal Bone Cyst (ABC)

Aneurysmal Bone Cyst (ABC) Aneurysmal Bone Cyst (ABC)

Expansile lesion

Respect epiphyseal plate

Almost invesible cortex

Thin internal trabeculations

soap-bubble

No periosteal reaction except in case of fracture

Doughnut sign in scintigraphy

Aneurysmal Bone cyst :Aneurysmal Bone cyst :

a.Occur secondary to fibrous dysplasia b.Can present with scoliosisc.May contain fluid-fluid level at MRId.Contain calcified matrixe.Doughnut sign at scintigraphy is

pathognomonic

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(√ )

(X )

(X )

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Multiple Myeloma

Mulyiple osteolytic Punched-out lesion

Absence of perilesional sclerosis

Mulyiple osteolytic Punched-out lesion

Complicated by pathological fracture

Associated with osteopenia

PET PET-CT coronal view

Regarding Multiple Myeloma :Regarding Multiple Myeloma :

a. It is the commonest 1ry neoplasm of bone

b. Generalised osteopenia is a recognised

appearance

c. Scintigraphy over-estimates disaese extent

d. Lesions becomes scleotic following

chemotherapy

e. Vertebral pedicle destruction is an early

event

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(√ ) also following radiotherapy

(X ) under estimates

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(√ ) in 15 %

(Ref: Grainger and Allison pp1913-1915,Daenhartppp121-122, Chapman 2003pp575-576)

Rheumatoid arthritis :Rheumatoid arthritis :

Articular erosion

Periarticular osteopeniaNarrowing of the joint spaces

Soft tissue swelling

Joint deformity

Joint instability due to ligament rupture

Narrowing of the glenohumoral joint

Marginal erosion

High ridding of the humerus

Lateral erosion of the clavicle

Erosion of the MTP Lateral deviation of toes , Hammer toes

Erosion of Odontoid process

Erosion of facet joints

Pannus proliferation directly compresses the spinal cord.

ligamentous destruction can result in atlantoaxial impaction

Erosion of the lateral 3Erosion of the lateral 3rdrd of the of the clavicle is seen in the following:clavicle is seen in the following:

a.Rheumatoid arthritis

b.Ankylosing spondylitis

c.Langerhans cell histiocytosis

d.Hypoparathyroidism

e.Multiple myeloma

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(X )

(√ )

(X ) Hyperparathyroidism

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Concerning Malignant Bone Lesions

Concerning Malignant bone lesion:Concerning Malignant bone lesion:

a. Chordoma is most common in the thoracolumbar

spine

b. Fibrosarcoma is the commonest tumour 2ry to paget’s

disease

c. Adamantinoma occursin the tibia in over 90% of

cases

d. Angiosarcoma has a soap bubble appearance at

radiography

e. Chondroblastoma are typically found in the

diaphysis

(X ) 90% in basisphenoid and sacrum

Sacral Chordoma

Basisphenoid Chordoma

Concerning Malignant bone lesion:Concerning Malignant bone lesion:

a. Chordoma os most common in the thoracolumbar

spine

b. Fibrosarcoma is the commonest tumour 2ry to paget’s

disease

c. Adamantinoma occurs in the tibia in over 90% of

cases

d. Angiosarcoma has a soap bubble appearance at

radiography

e. Chondroblastoma are typically found in the

diaphysis

(√ )

(X ) 90% in basisphenoid and sacrum

(√ )

Adamantinoma

Concerning Malignant bone lesion:Concerning Malignant bone lesion:

a. Chordoma os most common in the thoracolumbar

spine

b. Fibrosarcoma is the commonest tumour 2ry to paget’s

disease

c. Adamantinoma occursin the tibia in over 90% of

cases

d. Angiosarcoma has a soap bubble appearance at

radiography

e. Chondroblastoma are typically found in the

diaphysis

(√ )

(√ )

(√)

(X ) 90% in basisphenoid and sacrum

(X ) they are epiphyseal lesions

Chondroblastoma

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