Orthopedics study guide

Apr 16th, 2015
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BONE TUMORSPrinciples of management History-age,pain,swelling,trauma,neurologicalsymptoms,fracture Examinationlump/swelling,effusion,lymphatics,rest of thebodyPrinciples of management Imaging1. Plain x-rays-whichbone,where,margins,cortex,solitary/multiple,bony reaction,calcification,periostealreaction,soft tissues2. CT Scan3. MRI-spread in bone,soft tissue,blood vessel ALL DONE BEFORE BIOPSYPrinciples of management Laboratory work upanemia,ESR,ALP,B-J proteins,acidphosphatase,serum protein electrophoresisRoutine tests-LFT,RFT,CBC Biopsy-essential for diagnosis,save in a fewNeedle biopsy-expertise,areas not accessibleOpen biopsyTreatment optionsLeave aloneIntracapsular excision and currettageMarginal excisionWide excisionRadical excision/amputationLimb sparing surgeryChemotherapy-MTX,ADR,Cyclo,CisplatinRadiotherapyBENIGN BONE TUMORSOSTEOID OSTEOMAOSTEOBLASTOMAFIBROUS CORTICAL DEFECTGIANT CELL TUMORENCHONDROMAOSTEOCHONDROMABONE CYSTS-SIMPLE,ANEURYSMALOSTEOID OSTEOMA Males,<30 Femur,tibia Pain,typically relievedby salicylates X-ray:nidus,surroundedby sclerosis CT may show nidusbetter, ExcisionOSTEOBLASTOMAGiant osteoid osteomaMales,>30Flat bones,spinePain,muscle spasmX-ray:well demarcatedosteolytic lesion,flecksof calcification Excision and bonegraftingENCHONDROMA Isl

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