Musckuloskeletal MCQs

Aneurysmal Bone Cyst (ABC)

Aneurysmal Bone Cyst (ABC)

Respect epiphyseal
plate

soap-bubble
Thin internal
trabeculations

Almost invesible
cortex

Expansile lesion
No periosteal reaction except in
case of fracture

Doughnut sign in scintigraphy

Aneurysmal Bone cyst :

a.Occur

secondary to fibrous dysplasia ( )

( )
b.Can present with scoliosis
( )
c. May contain fluid-fluid level at MRI
d.Contain calcified matrix
(X )
e.Doughnut sign at scintigraphy is
pathognomonic
(X )

Multiple
Myeloma

Mulyiple osteolytic
Punched-out
lesion

Mulyiple osteolytic
Punched-out
lesion

Absence of
perilesional
sclerosis

Complicated by
pathological
fracture

Associated with
osteopenia

PET

PET-CT coronal view

Regarding Multiple Myeloma :

a. It

is the commonest 1ry neoplasm of bone

b. Generalised

osteopenia is a recognised

appearance
c.

( ) in 15 %

Scintigraphy over-estimates disaese

d. Lesions

( )

extent

(X ) under
estimates
becomes
scleotic
following

chemotherapy
e. Vertebral

( ) also following
radiotherapy early
pedicle destruction
is an

event
(X )
(Ref: Grainger and Allison pp1913-1915,Daenhartppp121-122, Chapman 2003pp575576)

Rheumatoid arthritis :

Joint deformity

Narrowing of the joint spaces

Periarticular osteopenia

Soft tissue swelling

Joint instability due to
ligament rupture
Articular erosion

High ridding of the humerus

Lateral erosion of
the clavicle

Marginal erosion

Narrowing of the glenohumoral joint

Lateral deviation
of toes ,
Hammer toes

Erosion of the MTP

Erosion of
Odontoid process

ligamentous destruction
can result in atlantoaxial
impaction

Pannus proliferation directly

compresses the spinal cord.
Erosion of facet joints

Erosion of the lateral 3rd of the

clavicle is seen in the following:
a.Rheumatoid
b.Ankylosing

spondylitis

c. Langerhans

(X )

cell histiocytosis

d.Hypoparathyroidism
e.Multiple

( )

arthritis

myeloma

(X )

(X ) Hyperparathyroidism
( )

Concerning
Malignant
Bone
Lesions

Concerning Malignant bone lesion:

a. Chordoma

spine

is most common in the thoracolumbar

(X ) 90% in basisphenoid and sacrum

b. Fibrosarcoma

is the commonest tumour 2ry to pagets

disease
c.

Adamantinoma occursin the tibia in over 90% of

cases

d. Angiosarcoma

has a soap bubble appearance at

radiography
e. Chondroblastoma

diaphysis

are typically found in the

Sacral Chordoma

Basisphenoid Chordoma

Concerning Malignant bone lesion:

a. Chordoma

spine

os most common in the thoracolumbar

(X ) 90% in basisphenoid and sacrum

b. Fibrosarcoma

is the commonest tumour 2ry to pagets

( )

disease
c.

Adamantinoma occurs in the tibia in over 90% of

cases

( )

d. Angiosarcoma

has a soap bubble appearance at

radiography
e. Chondroblastoma

diaphysis

are typically found in the

Adamantinoma

Concerning Malignant bone lesion:

a. Chordoma

os most common in the thoracolumbar

(X ) 90% in basisphenoid and sacrum

spine

b. Fibrosarcoma

is the commonest tumour 2ry to pagets

( )

disease
c.

Adamantinoma occursin the tibia in over 90% of

cases

( )

d. Angiosarcoma

radiography

has a soap bubble appearance at

()

e. Chondroblastoma

diaphysis

are typically found in the

(X ) they are epiphyseal lesions

Chondroblastoma

Thank
you