Immersion Education for Orthopaedic Pathology: A Review of the Orthopaedic In-Training Examination and American Board of Orthopaedic Surgery Certification.

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Immersion Education for Orthopaedic Pathology: A Review of the Orthopaedic In-Training Examination and American Board of Orthopaedic Surgery Certification by Derek F. Papp, James C. Johnston, John A. Carrino, Edward F. McCarthy, and Frank J. Frassica J Bone Joint Surg Am Volume 92(Supplement 2): December 1, 2010 ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1 This anteroposterior radiograph of the knee shows an osteosarcoma of the proximal part of the tibia. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2 This anteroposterior radiograph of the distal part of the femur shows a parosteal osteosarcoma. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3 This anteroposterior radiograph of the tibia shows a sunburst pattern of bone emanating from the tibial shaft, which is characteristic of a periosteal osteosarcoma. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 4 This anteroposterior radiograph of a chondrosarcoma in the femur shows the rings, arcs, and stipples present in any cartilage lesion. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 5 This anteroposterior radiograph of the distal part of the tibia shows a nonossifying fibroma. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 6 This lateral radiograph of the distal part of the femur shows an isolated, well- circumscribed osseous lesion—i.e., a bone island. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 7 This lateral radiograph of the knee shows an enchondroma in the distal part of the femoral shaft and the femoral metaphysis. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

This anteroposterior radiograph of the pelvis in a patient with Ollier disease shows multiple enchondroma lesions involving multiple bones. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

This anteroposterior radiograph of the distal part of the femur shows an isolated osteochondroma that shares the medullary cavity. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

This anteroposterior radiograph of the pelvis shows multiple hereditary exostoses in the pelvis with multiple bones affected. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 11 This anteroposterior radiograph of the knee shows multiple hereditary exostoses with the distal part of the femur and proximal part of the tibia more broad than normal and multiple sessile and pedunculated osteochondromas. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 12 This anteroposterior radiograph of lesion in the scapula shows a “hole within a hole,” characteristic of eosinophilic granuloma, or Langerhans-cell histiocytosis. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 13 This lateral radiograph of the spine shows vertebra plana (a collapsed vertebral body), which is characteristic of eosinophilic granuloma or Langerhans-cell histiocytosis. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 14 This lateral radiograph of the ankle shows a well-defined lytic lesion that involves the metaphysis and epiphysis (typical of a giant cell tumor). Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 15 Paget disease has radiographic features that can be seen on this anteroposterior radiograph of the left hip. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 16 This anteroposterior radiograph of the index finger shows an osteoid osteoma of the distal portion of the middle phalanx. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 17 As seen on this anteroposterior radiograph of the proximal part of the tibia, a chondroblastoma is an epiphyseal lesion with surrounding sclerosis and no evidence of bone destruction. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.

Fig. 18 This anteroposterior radiograph of the shoulder shows a unicameral bone cyst. Derek F. Papp et al. J Bone Joint Surg Am 2010;92: ©2010 by The Journal of Bone and Joint Surgery, Inc.