Bone Tumors and Fractures Stacy Fielding

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 www.marvistavet.com

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

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

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

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

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! Images courtesy of Dr. Pack

Fracture Types Complete Incomplete (greenstick) 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 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 http://cal.vet.upenn

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

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

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

Salter-Harris www.vetsurgerycentral.com