Anatomic Pathology Program

Orthopaedic (MSK) Pathology Elective


Rotation Director(s):

Elizabeth E. Frauenhoffer, MD
Karmaine Millington, MD

Goals and Objectives:

By the end of the rotation, the resident will be able to:

  • Create a schema of the major bone and soft tissue lesions according to age, location, cell type, and clinical presentation and behavior;
  • List the general categories of tumor types and know the criteria for benignity vs. malignancy;
  • Recognize the gross, cytologic, and histopathologic features of common bone and soft tissue lesions;
  • Recognize the basic radiographic features of the common bone lesions;
  • Understand the role of the pathologist in the diagnosis and evaluation of common bone and soft tissue tumors, including the role of FNAB and of tumor mapping for sarcomas.



  • Level of training: must be a senior Resident in HMC Pathology program
  • Prior approval by EEF and KAM, at least 3 months in advance


Duration and Timing of the Rotation:

  • 2 weeks – 2 four week blocks, depending upon the interests of the resident
  • Can be combined with another elective rotation

Teaching Staff:

Elizabeth E. Frauenhoffer, MD
Karmaine A. Millington, MD



1.  Self-Assessment:         

  • Take pre-test in MSK pathology within first few days of rotation; review answers with EEF or KAM; combination of images, glass slides, and written knowledge
  • Take post-test to assess progress (may be tailored depending on how rotation was structured)


2.  Background Reading (covered independently by resident):

  • Robbins Chapter 26 and 27 (Bone, Soft tissue, Joints, and associated sections covering Metabolic bone disease)
  • Corresponding chapters in Rosai or Silverberg's texts
  • Selected sections in Weiss, Huvos, Dorfman, McCarthy, WHO and AFIP fascicles and other MSK texts, as directed by rotation director(s)
  • Additional materials as posted on shared folder: \\\files\pathology\Shared\ResidentsandFellows\MSK Service reading and viewing materials


3.  Practical exposure to MSK material

  • Review study Sets in Bone, Joint and Soft Tissue/Derm (surgical path and cytology)
  • Review of all orthopedic surgical pathology and cytopathology material with attendings (EEF and KAM) during the month
  • In house cases - surgicals and cytopathology
    • Check OR and FNA schedule daily for upcoming cases
    • Plan on being present for frozen sections, gross dissections, and FNA's on these cases         
  • Consult cases
    • Review radiology images and slides prior to meeting with attending       
  • Attendance/presentations at patient care conferences:
    • Tuesday 7 am MSK conference (1st and 3rd Tuesday)
    • Monday 5 pm adult sarcoma conference (2nd Monday)
    • Friday 1 pm pediatric oncology conf (weekly) - if MSK cases are presented


4.  Didactic Learning

  • Attendance at Ortho Grand Rounds or Ortho Resident Course, if applicable topics presented


5.  Active learning/teaching activities (possible):

  • Presentation of 4 cases at Surg path unknown conference (Tuesday noon)
  • Present any bone and soft tissue cases at gross conference (Thursday noon)
  • Participation in MSK student lab as resource (MSk block in fall)


6.  Other potential activities (by mutual agreement, in advance):

  • Add cases to study sets
  • Develop teaching modules from study sets
  • Present cases at multidisciplinary conferences (MSK or adult sarcoma or peds oncology)
  • Write up case report


Method(s) of Evaluation:

  • Faculty observation
  • Review of pre and post test


Revised 9/2015