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Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Evaluation, Diagnosis, and Classification of Benign Soft-Tissue Tumors*†

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Presentation on theme: "Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Evaluation, Diagnosis, and Classification of Benign Soft-Tissue Tumors*†"— Presentation transcript:

1 Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Evaluation, Diagnosis, and Classification of Benign Soft-Tissue Tumors*† by FRANK J. FRASSICA, and ROBY C. THOMPSON J Bone Joint Surg Am Volume 78(1):126-40 January 1, 1996 ©1996 by The Journal of Bone and Joint Surgery, Inc.

2 Figs. 1-A and 1-B: Lipoma. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

3 Fig. 1-B: Coronal T2-weighted fast spin-echo scan showing a sharply marginated mass (asterisk) identical in signal and appearance to the subcutaneous fat. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

4 Hemangioma. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

5 Ganglion cyst. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

6 Figs. 4-A and 4-B: Photographs of the needle used for a core needle biopsy. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

7 Fig. 4-B: The plunger tip is extended as it would be to enter the tumor mass. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

8 Photomicrograph of a representative fragment of tissue obtained with a core needle biopsy (x 30). FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

9 Photograph demonstrating how the operative incision for the approach to an underlying tumor is outlined around the properly placed biopsy incision on the lateral aspect of the distal end of the thigh. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

10 Figs. 7-A and 7-B: Lipoma. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

11 Axial T1-weighted scan. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

12 Coronal T1-weighted image of a deep intramuscular lipoma. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

13 Axial T2-weighted image of the lipoma (asterisk) surrounding the proximal aspect of the radius and replacing the supinator muscle. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

14 Intramuscular lipoma. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

15 Figs. 10-A and 10-B: Meniscal cyst. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

16 Axial T2-weighted scan showing the characteristic appearance of a cystic lesion (asterisk) with a high-intensity, homogeneous signal and sharp margination. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

17 Figs. 11-A and 11-B: Hemangioma. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

18 Axial T2-weighted scan of the lesion, demonstrating a serpiginous-appearing subfascial mass (asterisk) with high signal intensity characteristic of large vascular spaces with very slow blood flow. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

19 Coronal T2-weighted image of the proximal aspect of a leg, revealing a small intramuscular hemangioma (asterisk) in the peroneus longus muscle that can be excised without functional compromise if pain dictates intervention. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

20 Nodular fasciitis. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

21 Figs. 14-A through 14-E: Heterotopic ossification. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

22 Figs. 14-B and 14-C: Anteroposterior and lateral radiographs of the same femur four weeks later, showing maturation of mineralization, with the most mature bone on the periphery of the mass (best seen on Fig. 14-C). FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

23 Figs. 14-B and 14-C: Anteroposterior and lateral radiographs of the same femur four weeks later, showing maturation of mineralization, with the most mature bone on the periphery of the mass (best seen on Fig. 14-C). FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

24 Axial T1-weighted image of the thigh, made at the same time as the initial radiograph in Fig. 14- A. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

25 Axial T2-weighted image made at the same time as Fig. 14-D, showing focal areas of low- intensity (dark) signal, consistent with calcification. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

26 Schwannoma of the radial nerve. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

27 Schwannoma of the radial nerve. FRANK J. FRASSICA, and ROBY C. THOMPSON, JR. J Bone Joint Surg Am 1996;78:126-40 ©1996 by The Journal of Bone and Joint Surgery, Inc.

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