Bone Tumors

Bone Tumors

1. Anatomy

   • Thigh compartments
     • Anterior
     • medial
     • posterior
   • bones
     • femur
       • Adductor tubercle
     • tibia
       • tibial tuborosity
     • fibula
     • patella
       • medial facet
       • lateral facet
   • Muscles
     • Anterior and medial
       • Psoas major
         • Flexion at hip joint
       • iliacus
       • pectinues
       • sartorius
       • quadriceps femoris
         • Vastus lateralis
         • vastus intermedius
         • vastus medialis
         • rectus femoris
       • Adductor muscles
         • longus
         • brevis
         • magnus
       • gracilis
     • posterior
       • Hamstrings
         • biceps femoris
         • semi-tendinosus
         • semi-membranosus
         • Ischial part of adductor magnus
         • flexion at Knee joint
   • neurovasculature
     • Femoral Nerve branches
       • muscular branches
         • nerve to pectinues
         • nerve to iliacus
       • Anterior division
         • cutaneous nerves
       • posterior division
         • sephenous nerve
     • Femoral Artery
       • branches
         • genicular artery
           • Knee anastomosis
         • perforating arteries
       • termination
         • popliteal artery
     • Sciatic nerve
       • tibial nerve
         • muscular branches
         • genicular branches
         • cutaneous nerve
           • sural nerve
       • lateral popliteal nerve
         • genicular branches
         • cutaneous branches
           • lat. cut. n. of calf
           • sural communi n.
   • Popliteal fossa
     • boundaries
       • upper lateral
         • biceps femoris
       • upper medial
         • semitendinosus + semimembranos
       • lower lateral
         • lat. head of gastrocnemius
       • lower medial
         • Med. head of gastrocnemius
     • roof
       • skin
       • fascia
     • content
       • popliteal vein

2. Physical Examination

   • Look
     • Gait
       • Symmetry
         • No limping
       • Spacing
         • space between two feet while walking
       • Base
         • space between two feet while standing
     • Walk heal to toe
     • Walk on toes
     • Walk on heels
     • Romberg's test
       • Feet close together, arms raised and closed eyes
     • Local inspection
   • Motor Assessment
     • Muscle Tone
       • Moving up and down
       • Flexion and extension the knee
       • Rolling the leg
     • Clonus
       • Patellar clonus
       • Ankle clonus
     • Reflexes
       • Knee Reflex
       • Ankle Reflex
       • Plantar Reflex
     • Power
       • movements
         • hip joint
         • knee
         • ankle
   • Sensory Assessment
     • joint position
     • vibration
     • light touch
     • pin prick
     • Finger-toe test
     • Rapidly foot tapping
     • Heel to shin test

3. bone histology

4. main features of bone tumors

   • Osteoma
     • Sites
       • Bones with intramembranous ossification
     • Radiologic Features
       • Usually round, radio dense
     • Gross
       • Exophytic sessile mass
     • MP
       • Mature dense compact cortical bone
   • Osteoid osteoma
     • Small , benign neoplasm
     • Evokes severe pain
       • relieved by aspirin
       • more at night
     • Site
       • Metaphysis of long bones
     • Radiological
       • nidus
       • sclerotic zone
       • Well circumscribed
     • Grossly
       • Small round mass
       • Well circumscribed
       • Hemorrhagic
       • gritty
     • MP
       • Interlacing trabeculae
       • Loose vascular CT stroma
   • Osteoblastoma
     • Site
       • Vertebral column
     • X- ray
       • nidus
       • nosclerotic zone
       • well circumscribed
   • Osteosarcoma
     • Radiological features
       • Destruction of the bone
       • codman’s triangle
       • sun ray appearance
     • Grossly
       • Large bulky mass
       • Grayish- white
       • mutton leg
     • MP
       • Osteoblastic areas
       • Pleomorphism & many mitotic figures
       • Osteoid formation
   • Osteochondroma
     • Radiological
       • Mushroom shaped
     • MP
       • exactly like normal bone layers
   • Enchondroma
     • Benign tumor of hyaline cartilage
     • Sites
       • Small bones of hand and feet
       • Long bones
   • Chondrosarcoma
     • Malignant cartilage forming tumor
     • Site
       • central skeleton
       • pelvic girdle
     • gross
       • Large, lobulated
       • bluish
     • Mode of growth
       • medullary cavity
         • cortex
           • soft tissue
   • Ewing's sarcoma

5. Treatment of bone tumor

   • Surgery
   • Radiation therapy
   • Chemotherapy
   • Cryosurgery

6. Limb saving procedure

   • The bone is replaced with an implant
   • Potential Late Effects after Limb Salvage
     • Nonunion
     • Limb-length discrepancy
     • Prosthetic loosening
     • Contractures
     • infections

7. Bone biopsy

   • a procedure in which bone samples are removed
   • 2 types
     • Needle biopsy
     • Open biopsy

8. Arthroplasty surgery

   • surgical procedure to restore the function of a joint
   • risks
     • Bleeding
     • Infection
     • Blood clots
     • Loosening of prosthetic parts.

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