Bone tumors and fractures
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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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Primary bone tumors

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


Primary bone tumors1

Appearance

Lysis

Sclerosis

Mixed

Periosteal reactions

Spiculated & fuzzy= active

Smooth & sharp = inactive

Amorphous = aggressive

Codman’s triangle >

Primary Bone Tumors

www.msu.edu


Primary bone tumors2

Ddx:

Fungal osteomyelitis

Bacterial osteomyelitis

Consider signalment, history and clinical signs

Biopsy to be sure!

Primary Bone Tumors

www.veterinaryradiology.net

coccidiomycosis


Metastatic bone tumors

Tumors that spread to bone:

mammary

lung

liver

thyroid

prostate

Metastatic Bone Tumors


Metastatic bone tumors1

Locations:

metaphysis OR diaphysis

vertebrae, ribs, femur, humerus

Appearance:

Similar to primary bone tumor

Ddx:

Fungal osteomyelitis

Bacterial osteomyelitis

Hepatozoonosis

Metastatic Bone Tumors


Approach to fractures
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


Look carefully
Look carefully!

Images courtesy of Dr. Pack


Fracture types

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


Fracture types cont d

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


Fracture types cont d1

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


Comminuted vs multiple

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


Compression vs impaction

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


Salter harris
Salter-Harris

www.vetsurgerycentral.com


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