Disorders of Bone Lab

This patient is presented to you with 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

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?!

This patient is presented to you with repetitive fractures of bones and this radiographic appearance:
1- What is abnormal in these two radiographic pictures?! 2- What is the most likely diagnosis?! 3- What is the abnormality leading to such condition?! 4- Name features of this condition 5- Name two dental complications of this condition when any of the jaws is involved

This patient is presented to you with this unique clinical appearance

1- What is abnormal in this clinical picture?! 2- What is the most likely diagnosis?! 3- What is the abnormality leading to such condition?! 4- What are the bones most commonly involved?! 5- What happens to the skull?!

This radiograph and clinical picture are taken for the same patient
1- Name some of the dental manifestations of this condition?!

This young adult is presented to you with gradually increasing painless diffuse bony swelling in the maxillary jaw bone that is associated with facial asymmetry. This bone is the only one affected. This is the result of the biopsy done!
1- What is the most likely diagnosis?! And to what category of lesions this condition 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?!

This patient is presented to you with gradually increasing painless diffuse bony swelling in the maxillary jaw bone that is associated with facial asymmetry. This bone is the only one affected. This is the result of the biopsy done!
4- Whom are usually affected?! 5- When is it usually diagnosed?! 6- The lesion is usually more pronounced buccally or palatally?! 7- Do maxillary lesions cross suture lines?!

This young adult is presented to you with this radiographic and 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 suitable time to treat this patient?! 3- What is the most suitable treatment: radiotherapy or Surgery?! And WHY?!

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 only one affected and the patient is presented clinically with gradually 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?!

This child is presented to you with multiple fractures and bony deformities arising in only one side of his body mainly over long bones of 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 be found?! 6- What is the Syndrome this condition is usually occurring with?! Can you name other manifestations of the syndrome?!

This patient is presented to you with multiple small lesions associated with apical area of lower incisors radiographically. The lesions are totally asymptomatic. No other bones or quadrants are involved. This is the result if the biopsy done!
1- What is the most likely diagnosis?! 2- What is the difference between this condition and fibrous dysplasia?! 3- Of the jaws, which is more commonly involved?! 4- Whom are usually affected?! Males or females?! 5- In the radiolucent stage, what are the differential diagnoses?!

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 other long bone lesions?!

This patient is presented to you with this unique clinical presentation

1- What do we call this appearance?! WHY?! 2- What is the most likely diagnosis?! 3- What is the abnormality leading to such condition?! 4- Of the jaws, which is more commonly 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?!

1- Describe this unique radiographic appearance for the same patient?! 2- Name dental abnormalities encountered in such patients?!

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 5 differential diagnoses?!

4- How can we differentiate these conditions from one another?! 5- What happens as the lesion matures?!

This patient is presented to you with this well-defined radiographic appearance in the mandible and in the long bone of the arm

This is the result of the biopsy done for the same patient
1- What is the most likely diagnosis?! 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 commonly involved?! 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 characterize brown tumor in the mandible?!

This child is presented to you with this clinical appearance. He has deformed limbs, severely curved sternum, enlarged costal cartilages, and flat skull
1- What is the most likely diagnosis?! 2- What is the most possible cause?! 3- Name dental abnormalities encountered in such patients?! 4- What is the difference between this condition and osteoporosis?!

This old patient is presented to you with this clinical appearance. 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 dental manifestations?!

This patient is presented to you with this clinical appearance. She has mildly painful swelling and extraoral sinus draining pus and this is her radiographic appearance
1- What is the most likely diagnosis?! 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?!

This is the result of the biopsy taken for the same patient
1- What do we call the structure marked by **?!

**

**

A young child is presented to you with bony hard swelling on the outer surface of the mandible and this unique radiographic appearance
1- What is the most likely diagnosis?! 2- What do we call this unique radiographic appearance?! 3- Whom are usually affected ?! 4- Of the jaws, which is more commonly involved?!

This adult patient is presented to you with this radiographic appearance Knowing that the lesion is asymptomatic and the tooth involved is non-vital
1- What is the most likely diagnosis?! 2- Give me other differential diagnoses?!

Adult patients are presented to you with this unique clinical appearance in the palate and the lingual aspect of the mandible. They are painless bony hard swellings and is slowly growing in size
1- What is the most likely diagnosis?! 2- Do we have to remove them?! 3- When it is necessary to surgically remove them?! 4- What are the clinical features of such condition?!

A patient is presented to you with this INCIDENTAL well defined radiopaque mass that is not surrounded with radiolucent band and found in the mandibular premolar region
1- What is the most likely diagnosis?! 2- Give me other differential diagnoses?!

A patient is presented to you with multiple peripheral painless slowly growing bony outgrowths on the buccal surface of the maxilla
1- What is the most likely diagnosis?! 2- If solitary, then differential diagnosis is?!

This 45 years old patient is presented to you with a chief complaint: My hat doesnt fit my head anymore and my denture is repetitively smaller than my ridges size
1- What is the most likely diagnosis?! 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?!

This is the result of the biopsy done for the same patient!
1- * refers to?! At what stage of the disease is seen?! And what do we call this histological appearance?! 2- Of the jaws, which is more commonly involved?! 3- What are the clinical manifestations of the disease?!

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 intraoral radiographs?! 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

An adult patient is presented to you with bony hard swelling and this radiographic appearance. Only the mandible is involved. This is the result of the biopsy done!
1- What are the differential diagnoses?! 2- What other tests should be done to reach final diagnosis?!

An adult patient is presented to you with these Radiographic and clinical pictures This peripheral solitary bony swelling is persistent and gradually increasing in size and it is painless and well circumscribed
1- What is the most likely diagnosis?! 2- What are the differential diagnoses for this lesion?! 3- If multiple then suspect what Syndrome?! What are its manifestations?!

Histologically and radiographically Osteoblastoma resembles cementoblastoma BOTH of which are well defined and Not related to the roots of teeth

A patient is presented to you with this unique radiographic appearance. Clinically he has swelling, pain and parasthesia in the lower lip and also ulceration, bleeding and mobility 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?!

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 pointed at by the black and white arrow heads respectively?!

A patient is presented to you with this Radiographic appearance. In the radiograph you 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
1- What is the most likely diagnosis?! 2- Give me 2 another differential diagnosis?!

A patient is presented to you with this Radiographic appearance. In the radiograph you can see well defined mixed lesion. This is the result of the biopsy done! In the histology we could find a wellencapsulated lesion too
1- What is the most likely diagnosis?! 2- What do we call this histological variant?! 3- Is there any clinical variant?! What are the features of this variant?!

A patient is presented to you with this Radiographic appearance where teeth are floating in the air. This is the result of the biopsy done! Clinically he is presented with gingival ulceration and bleeding
1- What is the most likely diagnosis?!

2- 1 and 2 refer to?!

This is an electron microscope appearance for the same patient 1- What do we call these structures pointed at by arrow heads?! 2- name another diagnostic tool to detect the lesion?!

This 65 years old patient is presented to you with this unique radiographic appearance and low back pain and also gingival swelling
1- What do we call this unique radiographic appearance?! 2- Is this lesion Monoclonal or polyclonal in origin?!

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?!

Immunohistochemistry for kappa light chain is (positive) and for lambda light chain is (negative)

A young adult patient is presented to you with bony hard swelling at the angle of the mandible. This is the result of the biopsy done
1- What is the most likely diagnosis?! 2- What are the structures pointed at the by the thick and thin arrow heads respectively?!