What Do You Know About Bone Lesions Symptoms and Types Flashcards

- a collection of non-neoplastic intraosseous lesions that replace normal bone and consist of a cellular fibrous CT within which non-functional osseous structures form
- normal bone is replaced by fibrous CT and becomes ossified in a non-functional manner (first is radiolucent then becomes radiopaque)
- 3 types - cemento-osseous lesions, fibrous dysplasia, cherubism

- benign fibro-osseous lesions of the jaws closely associated with the apices of the teeth and containing amorphous spherical calcifications thought to resemble an aberrant form of cementum
- lesion usually formed without any signs or symptoms
- these are localized to the jaws and start in the apical with 2 subtypes (localized, generalized)

- this is asymptomatic diffuse periapical radiolucent and radiopaque areas, primarily in the anterior mandible
- the cemento-osseous tissue replaces the normal bony archetecture
- most commonly an African American female where there is a symptomless radiolucency at the apex of a tooth
- this CANNOT be mistaken for an infection, clinical diagnosis

- note that this is usually present in the mandibular anterior but can be present in other regions as well
- we do not need a biopsy to confirm this diagnosis, confirmed by clinical presentation and radiograph
- the lesion is predisposed to infection and thus surgery will cause a possible unnecessary infection (possibly due to low vasculature)

- 1) - osteolytic (radiolucent) - cellular CT replaces normal PA trabecular bone
- 2) - cementoblastic (mixed RO & RL) where spherical calcifications fuse together and replace the CT
- 3) - mature - mostly radiopaque - sclerotic mineralized bone with some CT interspersed within the mass

- more common in women (90%)
- asymptomatic and are discovered accidentally
- diagnosed clinically and radiographically (should not be biopsied)
- no treatment is required

- diffuse asymptomatic radiopaque and radiolucent intraosseous areas of the cemento-osseous tissue that involves one or both arches (more generalized version of the periapical cemental dysplasia)
- lesions have the same clinical presentation as the periapical cemental dysplasia, again patients are commonly African American and female

- this is similar to the periapical cemental dysplasia in that the bone is replaced with fibrous tissue and it becomes ossified
- the difference is a gradual expansion of the bone and this is not unique to the bone
- this is an asymptomatic regional alteration of the bone in which the normal architecture is replaced by fibrous tissue and non-functional trabeculae-like osseous structures
- lesions may be monostotic or polystotic with or without associated endocrine disturbances

- a ground glass pattern is the type of radiographic change associated with this disease
- also has been described as a cotton ball
- histologically it resembles chinese characters which will become ossified

- this is the most common form of the monostotic type of fibrous dysplasia of the head and neck
- slow growing regional distortion that enlarges proportionately with the affected bone
- an aggressive type of juvenile FD has a faster growth rate causing more functional difficulties for the patient

- this is fibrous dysplasia in many bones without any oter clinical findings, referred to as the jaffe type
- patient with FD with functional disabilities, we wait until they mature and then can surgically recontour the affected bone

- this is a form of polystotic fibrous dysplasia in many bones associated with a hormonal disorder, and brownish skin lesions (cafe au lait) - brown pigmentation of the skin

- this is a rare form of the fibrous dysplasia occuring spontaneously in adults

- Surgery for establishment of function (speech, sight, breathing, mastication)
- surgery for cosmetic reasons after puberty in juvenile monostotic type

- autosomal dominant fibro-osseous lesion of the jaw involving more than one quadrant that stabilizes after the growth period, usually leaving some facial deformity and malocclusion
- lesion of the jaw and no other region, expansile lesion of the jaw
- occurs in males 2:1 males affected more severely
- more common in the mandible than in the maxilla
- biopsies produce an osteolytic lesion (fibrous lesion with multinucelated giant cells responsible for the radiographic appearance)