Monday, November 22, 2010

Update-FOGMACHINES is now AC

Forget all the other letters in the Mnemonic word FOGMACHINES. There are two left according to a new radioiligist describing the Skeletal survey. Bombarded with a hundred zillion x rays of just about every single bone,
There was a different opinion from that of the original reporting radiologist.
This one felt that the Lytic lesion is actually a single solitary expansile lesion. Expansile lesions are not the same animal as the lytic type. The Greek word for Lytic actually means "to separate" or break down, as in destroy.
Expansile has a less scary meaning compared to lytic. Both could be bad, especially in the presence of this much pain...More important, the radiologist describes a lesion which is non agressive in appearance, in other words a well defined sclerotic border, instead of the more scary ill defined squiggly lines of a cancerous bone tumor.

The two letter which are left are

Aneurysmal bone cyst



Where we go from here, nobody knows. The only thing we do know is... OW.

Wednesday, November 10, 2010

Let's Get Mnemonic

When you see lytic bone lesion think of FOGMACHINE.

Differential Diagnosis (Mnemonic = FOGMACHINES)
F = Fibrous Dysplasia
O = Osteoblastoma
G = Giant Cell Tumour
M = Metastasis / Myeloma
A = Aneurysmal Bone Cyst
C = Chondroblastoma
H = Hyperparathyroidism(brown tumours)/ Hemangioma
I = Infection
N = Non-ossifying Fibroma
E = Eosinophilic Granuloma / Enchondroma
S = Solitary Bone Cyst

11 choices, spin that wheel, where it stops, you'll still get the bill!

Friday, November 5, 2010

Full x-ray inventory of the skeleton and a rib biopsy

Next up: there will be full x-ray inventory of the skeleton and a rib biopsy.

The plot thickens. There is a suspicious lesion on the liver. There is a suspicious hideous looking lytic lesion on the left anterolateral seventh rib, which feels like a hot nail being driven in to the hilt. This rivals the notorious bone chip in the jaw bone, hunting season 2002, after a deep root cleaning by the worlds most nazi-like dentist ( who shall remain nameless). It is certain that the hygenist broke the rim of the molar and the fragment stayed down in there between the jaw and the gums until it worked it's way out of the bottom of the gumline a month later, after many dreams about being Steve Buscemi in "Fargo"...

"They froozhen shot me!!"
Now the recurring dream is of Wade Gustafson, saying to Carl Showalter "No money, no Jean!"..."No money, no Jean!"...and then he shot Carl Showalter (Steve Bucemi) in the face after Carl shoots him in the left anterolateral seventh rib....