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Bone Tumors and Fractures

Bone Tumors and Fractures. Stacy Fielding. OSA, CSA, FSA Solitary Metaphyseal location Long bones Rich blood supply “Away from elbow, toward the knee” Late stage disease Invade adjacent bones Cross joints Adjacent parenchymal organs. Primary Bone Tumors. www.marvistavet.com.

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Bone Tumors and Fractures

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  1. Bone Tumors and Fractures Stacy Fielding

  2. OSA, CSA, FSA Solitary Metaphyseal location Long bones Rich blood supply “Away from elbow, toward the knee” Late stage disease Invade adjacent bones Cross joints Adjacent parenchymal organs Primary Bone Tumors www.marvistavet.com

  3. Appearance Lysis Sclerosis Mixed Periosteal reactions Spiculated & fuzzy= active Smooth & sharp = inactive Amorphous = aggressive Codman’s triangle > Primary Bone Tumors www.msu.edu

  4. Ddx: Fungal osteomyelitis Bacterial osteomyelitis Consider signalment, history and clinical signs Biopsy to be sure! Primary Bone Tumors www.veterinaryradiology.net coccidiomycosis

  5. Tumors that spread to bone: mammary lung liver thyroid prostate Metastatic Bone Tumors

  6. Locations: metaphysis OR diaphysis vertebrae, ribs, femur, humerus Appearance: Similar to primary bone tumor Ddx: Fungal osteomyelitis Bacterial osteomyelitis Hepatozoonosis Metastatic Bone Tumors

  7. Approach to Fractures • Describe direction & location • Assess soft tissues • open vs. closed • foreign body • swelling • atrophy • Joint involvement • intra-articular fragments • Positional changes • name distal fragment relative to proximal

  8. Look carefully! Images courtesy of Dr. Pack

  9. Complete Involves both cortices Ex) Transverse, oblique, spiral Displacement, rotation Reduction may be needed Incomplete (greenstick) One cortex involved Bending force Does not over-ride Bending Stress microfracture, fissure Fracture Types http://cal.vet.upenn http://img.tfd.com

  10. Condylar Distal humerus, femur, proximal tibia, Medial or lateral Supracondylar = both fractured V, Y, T = condyles fracture from shaft and each other Fracture types – cont’d http://cal.vet.upenn

  11. Depression Sinuses or skull Multiple fissure lines join and bone collapses Lucent or sclerotic line Avulsion Forceful pull or muscle traction Apophyses +/- bone segment Fracture types – cont’d http://cal.vet.upenn

  12. Comminuted ≥3 fracture lines meeting at a singlepoint High energy trauma Butterfly fragments Multiple/segmental ≥3 fracture lines not meeting at a single point Independent of each other *Comminuted vs. Multiple http://cal.vet.upenn

  13. Compression Crushing injury Cancellous bone collapses Common in vertebrae Shortened bone length Impaction Fragment of bone driven into cancellous bone End of long bones Uncommon *Compression vs. Impaction

  14. Salter-Harris www.vetsurgerycentral.com

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