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3 Pertanyaan
1. Lesi : tumor >< infeksi
2. Benigna >< maligna
3. Primer >< sekunder ( metastase)
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Tipe tulang yang diserang :
1. Tumor primer : semua tulang
tapi terutama : pelvis, tulang panjang (
tulang sekitar hip dan knee joints)
Umur :
- Osteosarkoma : 10-15, > 50 tahun
- Ewingsarkoma : 5-15 thn
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Lesi
- Soliter : primer kecuali multiple
osteochondroma
- Multiple : metastase
korteks destruksi
reaksi periost (+)
- Transition zone :
Bila lebar tumor agresif
infeksi
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Metastase
- Letak lesi axial
- Jumlah > 1
- Gambaran :osteolitik
osteoblastik ( sklerotik)
campuran
- Asal primer gambaran berbeda
1. Ca mama : campuran
2. Ca prostat : osteoblastik
3. Ca ginjal : soliter, osteolitik
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OSTEOSARCOMA
- Paling sering : 10-25, > 50 thn
- Lokasi : sekitar lutut
humerus proksimal
pelvis
- Ro : - osteolitik, tidak tegas
- korteks periost keluar
- reaksi periost/Codman :
Sunray
Lamelar
- Ukuran destruksi
- DD : 1. Osteomielitis
2. Ewing sarcoma
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Anteroposterior radiograph of a typical mixed Lateral radiograph of a sclerotic osteosarcoma (arrow)
sclerotic and lytic osteosarcoma arising from the arising in the proximal metaphyseal region of the right tibia
right proximal humerus in a 16-year-old girl. The in a 16-year-old boy.
tumor has penetrated the bone and formed a soft
tissue mass (stage IIB; see Table 4). Note the
ossifications in the surrounding soft tissue (arrows). 10
Osteosarcoma arising from the right proximal humerus in a 16-year-old girl. (Left) Anteroposterior radiograph of the
tumor (arrow) obtained before the institution of induction chemotherapy. (Right) Anteroposterior radiograph of the
same tumor after two cycles of induction chemotherapy. Extensive calcification of the lesion (arrow) indicates a good
response to treatment 11
EWING SARCOMA
- Pada diafisis
- 5-15 thn
2. Osteomielitis
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Osteochondroma
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RHEUMATOID ARTHRITIS
Stage I : periarticular osteoporosis
- soft tissue swelling
Stage II : Celah sendi ↓
Stage III: Destruksi cartilago + tulang
Stage IV : Ankilose
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OSTEOARTHRITIS
1. Osteofit
2. Celah sendi ↓
3. Subchondral osteosklerotik
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GOUTY ARTHRITIS
1. Celah sendi ↓
2. Subchondral osteosklerotil
5. Ankilose
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