Mind map

"A Swelling In The Leg"

Lelas A English

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ANATOMY OF THE THIGH
- Muscles: Hip flexors, knee extensors
- Nerves
- Arteries
- Adductor canal
- Hamstrings muscles:
- EXAMINATION OF THE THIGH
  - Gait
    - Symmetry (No limping).
    - Spacing (the space between two feet while walking.).
    - Base (the space between two feet while standing.).
  - Movement
  - Dermatomes
CLASSIFICATION OF BONE TUMORS
- Primary Tumors
  - Formed de novo, within the bone itself
    - Classified based on its many characteristics like size, borders, activity, etc.
- Secondary Tumors
  - Mainly metastatic tumors that originate from other parts of the body and spread to bones.
  - OSTEOSARCOMA
    - Malignant tumor of mesenchymal cells characterized by direct formation of osteoid or bone matrix by the tumor cells*
      - osteoid material in direct contact with pleomorphic malignant cells
    - Risk factors
      - Teenage growth spurts
      - Higher height than normal (longer bones)
    - Symptoms
      - Fragility fracture
      - Pain in the affected bone
    - Primary osteosarcoma
      - Males > females
      - Genetic factors: mutations in 1retinoblastoma gene, and 2-P53 gene.
      - : Metaphysis of long bones, lower end femur, upper end tibia.
    - Secondary osteosarcoma
      - Older than 40 years
      - flat bones > long bones
      - Ionizing radiations: Radiotherapy
    - INVESTIGATIONS OF OSTEOSARCOMA
      - X-ray
      - MRI
      - Ultrasound
      - CT scans
      - Bone scans
      - PET" Scan
    - TREATMENT OF OSTEOSARCOMA
      - Surgery
        to remove the cancer only (limb-sparing surgery)
        to remove the affected limb (amputation)
      - Chemotherapy
      - Radiation therapy
- INVESTIGATIONS OF BONE TUMORS
  - History
  - Physical examination
  - Lab test
    - CBC
    - Blood chemistry panel
  - Imagining test
    - X-ray
    - Radio-isotopic study
  - Biopsy
    - BIOPSY FROM A BONE TUMOR
      - Needle Biopsy
      - Open Biopsy
      - Why might I need a bone biopsy?
        Evaluate bone pain or tenderness.
        Investigate an abnormality seen on X-ray.
        Find out if a bone tumor is malignant or benign.
        cause of an unexplained infection or inflammation.
        What are the risks of a bone biopsy?
        Bruising and discomfort at the biopsy site.
        Bone fracture.
        Prolonged bleeding from the biopsy site.
        Infection near the biopsy site or in the bone
- TREATMENT OF BONE TUMORS
  - Benign bone tumors :
    - can be treated by medication
      - need often check up(x-rays)
        some may disappear by their own
  - Malignant bone tumors :
    - Radiational therapy
      - chemotherapy
  - Surgical treatment
    - excision of the benign tumor
      - Limb salvage surgery/amputation for malignant tumor
- EPIDEMIOLOGY OF BONE TUMORS
  - Osteochondroma: affects mostly males less than 25 Y.O.
  - Osteoma: middle aged individuals.
  - Osteoblastoma: males more than females
  - Osteoid osteoma: adults less than 25 Y.O
  - How common is osteosarcoma?