By Maximilian Reiser, Andrea Baur-Melnyk, Christian Glaser
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Extra info for Musculoskeletal Imaging ( DX- Direct )
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Reid R. Chondrosarcoma of small bones of the hand. J Hand Surg Br 2003: 28(6): 602-608 54 Definition ~ Epidemiology Second most common malignant bone tumor in children. Age 9-18 • Ratio of boys to girls is 3:2. ~ Etiology, pathophysiology, pathogenesis Highly malignant tumor arising from the bone marrow. No production of tumor matrix. Imoging Signs ............................................................................................ ~ Modality of choice MRJ• Radiographs in two planes. ~ Pathognomonic findings Aggressively growing bone tumor found in children and adolescents.
Synovial membrane metaplasia. Nodular cartilage proliferations that may ossify. Nodular proliferations are attached by stalks to the synovial membrane. which nourishes them • Primary disease is idiopathic: secon- dary disease occurs with joint deterioration and arthritis. Imoging Signs ............................................................................................ • Modality of choice Radiographs in two planes. • Radiographic findings Round. smoothly bordered calcifications near the joint.
Alkaline phosphatase levels are typically elevated. while calcium and phosphate levels are normal. New pain related to the lesion suggestive of malignant transformation. • Treatment options Calcitonin (inhibits osteoclastic activity) and bisphosphonates reduce disease activity. • Course and prognosis Follow-up radiographs and serum alkaline phosphatase testing to monitor disease course and activity. Malignant degeneration occurs in 1%: osteosarcoma. fibrosarcoma. giant cell tumor. Occasionally Paget arthropathy develops Uoint degeneration and deformity) • Compression of cranial nerves may occur if skull base involved.