Transcript Bone Tumors and Fractures - University of Prince Edward Island

Bone Tumors and
Fractures
Stacy Fielding
Primary Bone Tumors
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OSA, CSA, FSA
Solitary
Metaphyseal location
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Long bones
Rich blood supply
“Away from elbow, toward
the knee”
Late stage disease
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Invade adjacent bones
Cross joints
Adjacent parenchymal organs
www.marvistavet.com
Primary Bone Tumors
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Appearance
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Lysis
Sclerosis
Mixed
Periosteal reactions
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Spiculated & fuzzy=
active
Smooth & sharp =
inactive
Amorphous = aggressive
Codman’s triangle >
www.msu.edu
Primary Bone Tumors
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Ddx:
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Fungal osteomyelitis
Bacterial osteomyelitis
Consider signalment,
history and clinical
signs
Biopsy to be sure!
www.veterinaryradiology.net
coccidiomycosis
Metastatic Bone Tumors
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Tumors that spread to
bone:
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mammary
lung
liver
thyroid
prostate
Metastatic Bone Tumors
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Locations:
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Appearance:
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metaphysis OR diaphysis
vertebrae, ribs, femur,
humerus
Similar to primary bone
tumor
Ddx:
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Fungal osteomyelitis
Bacterial osteomyelitis
Hepatozoonosis
Approach to Fractures
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Describe direction & location
Assess soft tissues
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Joint involvement
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open vs. closed
foreign body
swelling
atrophy
intra-articular fragments
Positional changes
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name distal fragment relative to proximal
Look carefully!
Images courtesy of Dr. Pack
Fracture Types
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Complete
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Incomplete (greenstick)
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Involves both cortices
Ex) Transverse, oblique, spiral
Displacement, rotation
Reduction may be needed
http://cal.vet.upenn
One cortex involved
Bending force
Does not over-ride
Bending
Stress microfracture, fissure
http://img.tfd.com
Fracture types – cont’d
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Condylar
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Distal humerus, femur, proximal tibia,
Medial or lateral
Supracondylar = both fractured
V, Y, T = condyles fracture from shaft and each other
http://cal.vet.upenn
Fracture types – cont’d
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Depression
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Sinuses or skull
Multiple fissure lines
join and bone collapses
Lucent or sclerotic line
Avulsion
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Forceful pull or muscle
traction
Apophyses
+/- bone segment
http://cal.vet.upenn
*Comminuted vs. Multiple
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Comminuted
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≥3 fracture lines meeting
at a single point
High energy trauma
Butterfly fragments
Multiple/segmental
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≥3 fracture lines not
meeting at a single point
Independent of each
other
http://cal.vet.upenn
*Compression vs. Impaction
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Compression
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Crushing injury
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Cancellous bone collapses
Common in vertebrae
Shortened bone length
Impaction
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Fragment of bone driven
into cancellous bone
End of long bones
Uncommon
Salter-Harris
www.vetsurgerycentral.com