Disorders of Bone Lab

7/30/2019 Disorders of Bone Lab

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Disorders of Bone Lab


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This patient is presented to youwith repetitive fractures of the

same bone and this clinical

appearance:

1- What is abnormal in these two clinical

pictures?!

2- What is the most likely diagnosis?!

3- What is the abnormality leading to

such condition?!

4- Name other features of this condition


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These are clinical and

radiographic pictures taken

for the same patient

1- What is abnormal in these

clinical and radiographic

pictures?!

2- What is the most possible

diagnosis?!

3- Is this condition and

osteogenesis imperfecta carried

on the same gene?!


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This patient is presented to you

with repetitive fractures ofbones and this radiographic

appearance:

1- What is abnormal in these two

radiographic pictures?!

-


such condition?!

4- Name features of this condition

5- Name two dental complications of

this condition when any of the jaws is

involved


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This patient is presented to you

with this unique clinical

appearance

1- What is abnormal in this clinical

picture?!

- a s e mos e y agnos s


such condition?!

4- What are the bones most

commonly involved?!

5- What happens to the skull?!


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This radiograph and

clinical picture aretaken for the same

patient

1- Name some of the

dental manifestations of

this condition?!


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This young adult is presented to you

with gradually increasing painless

diffuse bony swelling in themaxillary jaw bone that is

associated with facial asymmetry.

This bone is the only one affected.

This is the result of the biopsydone!

1- What i the mo t likel dia no i ?!

And to what category of lesions thiscondition is related to?!

2- Of the jaws, which is more commonly

involved?!

3- When the maxilla and anatomically

adjacent bones get involved, what do we

call this condition then?!


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This young adult is presented

to you with this radiographicand histological appearances.

This bone is the only one

affected and clinically theres a

gradually increasing painless

diffuse bony swelling. This is

the result of the biopsy done!

1- What is the affected site?! How

did you know?!

2- When is it the most suitabletime to treat this patient?!

3- What is the most suitable

treatment: radiotherapy orSurgery?! And WHY?!


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This patient is presented to you with

this radiographic and histological

appearances

1- What do we call this unique radiographic

appearance on intraoral radiographs?!

2- Is the lesion well defined?!

3- If this bone is the onl one affected and

the patient is presented clinically withgradually increasing painless diffuse

swelling, then what is the most likely

diagnosis?!

4- Abnormal bone is referred to by 1 or 2?!

5- At what stage this patient is?!

Radiolucent, Mixed or Radiopaque stage?!

1 2


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This child is presented to you with multiple

fractures and bony deformities arising in only

one side of his body mainly over long bonesof limbs and this unique skin pigmentation.

This is the result of the biopsy done

1- What is the most likely cause of the segmental

bony fractures?!

2- Whom are usually affected?! Males or females?!

3- When is it usually diagnosed?!

4- What do we call these skin pigmentations?!

5- What biochemical abnormality might befound?!

6- What is the Syndrome this condition is usually

occurring with?! Can you name other

manifestations of the syndrome?!


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multiple small lesions associated with

apical area of lower incisorsradiographically. The lesions are totally

asymptomatic. No other bones or

quadrants are involved. This is the

result if the biopsy done!


- at s t e erence etween t s

condition and fibrous dysplasia?!


involved?!

4- Whom are usually affected?! Males or

females?!

5- In the radiolucent stage, what are thedifferential diagnoses?!


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A patient is presented to you with

this unique histological appearance:

1- Describe it! And describe what has

happened?!

2- 1 and 2 refer to?!

3- To what category of lesions this

appearance is linked and can you give

me 3 differential diagnoses?!

4- How can we differentiate these

conditions from one another?!

5- How can we differentiate dysplasias

from neoplasia clinically,radiographically and histologically?!

6- What happens as the lesion matures?!

And how jaw lesions differ from otherlong bone lesions?! 1 2


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This patient is presented to you with this

unique clinical presentation

1- What do we call this appearance?! WHY?!


3- What is the abnormality leading to such

condition?!


involved?!

5- Whom are usually more affected males or

females?!

6- Describe growth pattern this condition has:

A- When does it begin?!B- Period of rapid growth?!

C- Period of regression?!

7- Do these patients require treatment?!


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1- Describe this unique radiographic appearance forthe same patient?!

2- Name dental abnormalities encountered in suchpatients?!


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A patient is presented to you with this

unique histological appearance:

1- Describe it! And describe what has

happened?!


3- To what category of lesions this

appearance is linked and can you give me

4- How can we differentiate these

conditions from one another?!

5- What happens as the lesionmatures?! 1 2


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This patient is presented to you with this well-definedradiographic appearance in the mandible and in the long bone

of the arm


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This is the result of the biopsy

done for the same patient


2- What is the best way to confirm

diagnosis?!

3- What biochemical changes we might

find?!

4- Whom are usually affected?!

5- Of the jaws, which is more commonlyinvolved?!

6- What are the symptoms associated with

severe cases?!

7- If patient is presented to you with

multiple or recurrent giant cell granuloma

of jaws, what should you do?!

8- What might radiographically characterizebrown tumor in the mandible?!


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This child is presented to you with this

clinical appearance. He has deformed

limbs, severely curved sternum,

enlarged costal cartilages, and flat skull


2- What is the most possible cause?!

3- Name enta a norma t es encountere n

such patients?!

4- What is the difference between this

condition and osteoporosis?!


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This old patient is presented to

you with this clinicalappearance. He has enlarged

jaws, hands and feet

1- What is the most likely diagnosis

2- What is the most likely cause?!

3- What are the dentalmanifestations?!


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this clinical appearance. She has

mildly painful swelling and extraoralsinus draining pus and this is her

radiographic appearance


2- What do we call this unique

radiographic appearance?!

3- What is the most commonly cause?!

4- Of the jaws, which is more

commonly involved?! Why?!

5- Eventually, what does this condition

result in?!


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taken for the same patient

1- What do we call the structure

marked by **?!

**

**


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A young child is presented to you

with bony hard swelling on the

outer surface of the mandible

and this unique radiographic

appearance


2- What do we call this unique

radiographic appearance?!

3- Whom are usually affected ?!

4- Of the jaws, which is morecommonly involved?!


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This adult patient is presented toyou with this radiographic

appearance

Knowing that the lesion is

asymptomatic and the toothinvolved is non-vital

-

2- Give me other differential

diagnoses?!


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Adult patients are presented to

you with this unique clinicalappearance in the palate and the

lingual aspect of the mandible.

They are painless bony hard

swellings and is slowly growing

in size


2- Do we have to remove them?!

3- When it is necessary to surgicallyremove them?!

4- What are the clinical features of

such condition?!


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A patient is presented to you

with this INCIDENTAL welldefined radiopaque mass that is

not surrounded with radiolucent

band and found in the

mandibular premolar region


2- Give me other differential

diagnoses?!


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A patient is presented

to you with multipleperipheral painless

slowly growing bony

outgrowths on the

buccal surface of the

maxilla

1- What is the most likelydiagnosis?!

2- If solitary, then

differential diagnosis is?!


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This 45 years old patient is presented

to you with a chief complaint: My

hat doesnt fit my head anymore andmy denture is repetitively smaller

than my ridges size


2- What is the abnormality in this

condition?!

3- What is the possible etiology?!

4- What are the different stages of the

disease?!

5- What are the complications of:

A- First phase?!

B- Second active phase?!

C- Third phase?!


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This is the result of the

biopsy done for the samepatient!

1- * refers to?! At what stage of

the disease is seen?! And what dowe call this histological

appearance?! *

2- Of the jaws, which is morecommonly involved?!

3- What are the clinical

manifestations of the disease?!


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This is the result of the skull

radiograph done for the same patient!

1- What do we call this unique radiographic

appearance?!

2- What might we find in intraoralradiographs?!

3- What type of malignancy is common in these

patients?!

3- Other methods to confirm diagnosis other

than radiographic, clinical and histological

appearances?!

4- Describe:

A- Serum calcium levels

B- Serum phosphate levels

C- Alkaline phostphatase levels


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An adult patient is presented

to you with bony hard

swelling and this radiographicappearance.

Only the mandible is

involved.


done!

1- What are the differential

diagnoses?!

2- What other tests should be done

to reach final diagnosis?!

A d lt ti t i t d t


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An adult patient is presented to

you with these Radiographic

and clinical picturesThis peripheral solitary bony

swelling is persistent and

gradually increasing in size and

it is painless and well

circumscribed

- a s e mos e y agnos s

2- What are the differential diagnoses

for this lesion?!

3- If multiple then suspect whatSyndrome?! What are its

manifestations?!


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Histologically and

radiographicallyOsteoblastoma resembles

cementoblastoma BOTH of

which are well defined andNot related to the roots of

teeth


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with this unique radiographic

appearance. Clinically he has

swelling, pain and parasthesia

in the lower lip and also

ulceration, bleeding andmobility of teeth

1- What is the most likely

diagnosis?!

2- What do we call this radiographic

appearance?! And is it always seen

in every patient?!

3- Which has better prognosis,

central or peripheral lesions,

mandibular or maxillary lesions?!


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These are radiographic and

histological pictures for a

patient having the same

condition discussed in the

previous slide

1- What is the most important

radiographic feature associated with

condition and seen here?!

2- What are the structures pointedat by the black and white arrow

heads respectively?!



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with this Radiographic

appearance. In the radiographyou can see well defined

corticated radiolucency. This is

the result of the biopsy done!

In the histology we could find

a well-encapsulated lesion too

- at s t e most e y

diagnosis?!

2- Give me 2 another differential

diagnosis?!



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with this Radiographic

appearance. In the radiographyou can see well defined

mixed lesion. This is the result

of the biopsy done! In the

histology we could find a well-encapsulated lesion too

- at s t e most e y

diagnosis?!

2- What do we call this

histological variant?!

3- Is there any clinical variant?!

What are the features of this

variant?!

A i i d i h


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A patient is presented to you with

this Radiographic appearance

where teeth are floating in the air.


done!

Clinically he is presented withgingival ulceration and bleeding

1- What is the most likel dia nosis?!


1

2


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This is an electron

microscope appearance for

the same patient

1- What do we call these

structures pointed at by

2- name another diagnostic

tool to detect the lesion?!

Thi 65 ld


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This 65 years old

patient is presented to

you with this unique

radiographic

appearance and low

back pain and alsogingival swelling

-

unique radiographicappearance?!

2- Is this lesion Monoclonal

or polyclonal in origin?!

This is the


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This is the

histological

appearance for the

same patient

And also the

immunochemistry

representation

1- * refers to?!

2- What do we call

this

immunochemistry

representation?!

3- Name other

diagnostic tools?!

*


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Immunohistochemistry

for

(positive) and forlambda light chain is

(negative)

A young adult patient is


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A young adult patient is

presented to you with bony hard

swelling at the angle of themandible. This is the result of the

biopsy done


2- What are the structures pointed at

t e y t e t c an t n arrow ea s

respectively?!


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Documents

Disorders of Bone Lab