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143 Cards in this Set
- Front
- Back
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A chronic disorder of the ADULT skeleton in which normal osseous tissue is replaced by a highly vascular fibrous osteoid.
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Paget's Disease
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AKA for Paget's Disease
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Osteitis Deformans
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What are the 4 phases of Paget's Disease?
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1) Osteolytic phase
2) Active osteolysis/osteogenesis 3) Inactive osteoblastic/sclerotic phase 4) Malignant Degeneration |
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"Tile-like or mosaic pattern" of cortical and cancellous bone is pathognomonic.
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Paget's Disease
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Consistency of dry bread.
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Paget's Disease
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Increase in skull size (enlarged calvarium).
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Paget's Disease
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Warmth of surrounding skin.
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Paget's Disease
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Apparent increase in length of arms due to shortened spine.
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Paget's Disease
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Hobbling gate
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Paget's Disease
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Basilar invagination with possible brain stem compression.
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Paget's Disease
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Bowing deformities of long bones.
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1) Paget's Disease
2) Fibrous Dysplasia |
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Kyphosis, scoliosis
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Paget's Disease
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Pseudofractures
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Paget's Disease
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"Looser's lines"
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Paget's Disease
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"Milkman's Syndrome"
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Paget's Disease
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Increased alkaline phosphatase up to 20X normal.
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Paget's disease
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Urinary excretion of hydroxyproline - collagen destruction.
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Paget's Disease
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Salycilates and NSAIDS for analgesic properties.
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Paget's Disease
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A slow progressive physiological resorption of normal bone which is replaced by fibrous tissue mixed w/ poorly-formed, haphazardly-arranged trabeculae of woven bone.
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Fibrous Dysplasia
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"The great imitator of bone dx"
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Fibrous Dysplasia
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Growing fibrous neoplasm
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Fibrous Dysplasia
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Age of onset 8-14 years
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Fibrous Dysplasia
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In females with McCune-Albright Syndrome.
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Fibrous Dysplasia
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Focal disorder of bone maturation w/arrest at immature stage of woven bone.
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Fibrous Dysplasia
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Aberrant maturation of bone.
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Fibrous Dysplasia
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Localized defects arising in medullary cavity. Fibrous matrix with intermix of scattered bony spicules
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Fibrous Dysplasia
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Disorganized ground-glass appearance.
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Fibrous Dysplasia
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Endosteal scalloping
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Fibrous Dysplasia
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Cortical lesions usually covered by at least a thin shell of normal cortex.
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Fibrous Dysplasia
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Expands and deforms bone but does not break cortex.
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Fibrous Dysplasia
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3 Clinical Patterns of Fibrous Dysplasia?
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1) Monostotic fibrous dysplasia
2) Polyostotic fibrous dysplasia 3) Polyostotic fibrous dysplasia w/endocrine abnormality |
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Associated with skin pigmentation and precocious sexual development.
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McCune-Albright Syndrome
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Cafe au lait spots
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1) Fibrous Dysplasia
2) Neurofibromatosis |
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"coast of Maine"
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Fibrous Dysplasia
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Pathological fractures cause persistant pain esp. weight-bearing bones
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Fibrous Dysplasia
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Non-elevated patches of increased melanin.
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Fibrous Dysplasia
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Well demarcated with "ring" of sclerosis.
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Fibrous Dysplasia
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Widened medullary cavity, bone expansion.
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Fibrous Dysplasia
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Pathological fracture
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Fibrous Dysplasia
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AKAs for Neurofibromatosis?
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1) von Recklinghausen's Disease
2) "Elephant man" Disease |
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A congenital, inherited autosomal dominant disorder.
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Neurofibromatosis
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Fibroma molluscum (multiple, soft, elevated cutaneous tumors)
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Neurofibromatosis
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Osseous deformities of axial & appendicular skeleton.
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Neurofibromatosis
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Tumors of peripheral, optic & acoustic nerves.
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Neurofibromatosis
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Tumor of nerve root sheath.
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Neurofibromatosis
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"Coast of California"
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Neurofibromatosis
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6 or more cafe au lait spots > or equal to 1.5 cm in diameter.
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Neurofibromatosis
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Kyphoscoliosis of lower thoracic spine.
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Neurofibromatosis
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Cervical kyphosis is common.
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Neurofibromatosis
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May include paraplegia.
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Neurofibromatosis
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atlanoaxial subluxation causing possible suboccipital headaches and motor weakness to upper extremities.
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Neurofibromatosis
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Blindness and deafness
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Neurofibromatosis
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"dumb-bell" neurofibroma of spinal nerve (enlarged IVF)
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Neurofibromatosis
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Radiographic finding of decreased bone density.
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Osteopenia
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A decrease in total bone mass greater than what is expected for a given age, race, sex. Bone that is present is normal in composition.
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Osteoporosis
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Normal ratio of osteoid to bone mineral.
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Osteoporosis
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A systemic disorder that affects the entire skeleton but is most clinically significant in the axial skeleton. Loss of both cortical and trabecular bone.
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Osteoporosis
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On the DEXA, it is anything from -2.5 and below bone mineral density.
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Osteoporosis
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On the DEXA, it is from -2.5 to -1 bone mineral density.
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Osteopenia
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Palpable paravertebral muscle spasms.
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Osteoporosis
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3 major areas of fracture are vertebrae, wrist and hip.
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Osteoporosis
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"Pencil-thin" cortex
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Osteoporosis
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"Coarsened" trabecular pattern
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Osteoporosis
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Bone softening
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Osteomalacia
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Osteomalacia in children.
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Rickets
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Vitamin D deficiency
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Osteomalacia
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Vitamin D contributes to bone mineralization by ______?
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Promoting absorption of calcium in the gut.
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What reacts with sunlight to become Vitamin D?
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7-dehydrocholesterol
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Muscle tetany and weakness
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rickets
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listlessness and irritability
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rickets
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delayed skeletal development
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rickets
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bone deformity - bends
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rickets
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diffuse bone pain, tenderness to palpation
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osteomalacia
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wide epiphyseal plate
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rickets
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"frayed" metaphysis
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rickets
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Treatment is to increase vitamin D.
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Osteomalacia/Rickets
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What hormone functions to elevated blood levels of calcium?
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Parathyroid hormone
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Osteopenia of all skeletal structures.
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hyperparathyroidism
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subperiosteal bone resorptioin
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hyperparathyroidism
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"lace-like" outer cortical margins.
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hyperparathyroidism
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infection of bone
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osteomyelitis (suppurative)
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staph aureus
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osteomyelitis
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4 pathways for invasion of bone?
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1) hematogenous spread
2) contiguous source 3) direct implantation 4) postoperative (iatrogenic) |
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In children: extremities
acute process |
osteomyelitis
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In adults: spinal involvement
chronic process |
osteomyelitis
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necrotic fragment of bone
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osteomyelitis
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Define sequestrum.
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necrotic fragment of bone
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collar of new bone
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osteomyelitis
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Define involucrum.
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collar of new bone
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Adults have history of pre-existing infection.
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osteomyelitis
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non-suppurative osteomyelitis
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Tubercular spondylitis
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AKA for Tubercular spondylitis
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Pott's disease of the spine
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Infection of bone by Mycobacterium tuberculosi.
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Tubercular spondylitis
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Hematogenous spread of a primary focus from the respiratory tract.
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Tubercular spondylitis
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Latent period of 21 days
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Tubercular spondylitis
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Gibbus deformity
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tubercular spondylitis
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AKAs for osteochondrosis.
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1) osteonecrosis
2) avascular necrosis 3) asceptic necrosis |
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Death of bone cells and marrow due to vascular compromise.
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osteochondrosis
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a benign, self-limiting disorder, takes 2-8 years to heal.
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osteochondrosis
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most common form of avascular necrosis.
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Legg-Calve-Perthes disease
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idiopathic avascular necrosis of femoral capital epiphysis prior to closure of the growth plate.
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Legg-calve-perthes disease
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In children ages 5-7.
boys 5X girls usually unilateral |
Legg-calve-perthes disease
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gradual onset of limp and groin pain which radiates to anteromedial knee.
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Legg-calve-perthes disease
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ROM is painful especially in abduction and interal rotation.
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Legg-calve-perthes disease
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Thigh muscles may atrophy.
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Legg-calve-perthes disease
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Xray hallmark is sclerotic appearance of bone.
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legg-calve-perthes disease
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Osteochondrosis of tibial tubercles.
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Osgood-Schlatter's Disease
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Thought to be disruption/avulsion of tibial tubercle at insertion of patellar ligament.
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osgood-schlatter's disease
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Most common in boys aged 11-15.
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osgood-schlatter's disease
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Usually associated with history of a single violent trauma or repeated knee flexion.
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osgood-schlatter's disease
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Heals by about age 18
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osgood-schlatter's disease
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juvenile hyperkyphosis
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scheuermann's disease
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kyphosis and back pain due to anterior wedging of vertebral bodies
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scheuermann's disease
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trauma to vertebral ring epiphysis
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scheuermann's disease
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boys aged 13-17
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scheuermann's disease
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protruberant abdomen
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scheuermann's disease
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irregular end-plates with schmorl's nodes
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scheuermann's disease
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an inherited defect of connective tissue (multiple systems disorder)
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osteogenesis imperfecta
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Most serious in the skeleton. Also eyes, ears, joints, ligaments, and teeth.
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osteogenesis imperfecta
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Impaired formation of type I collagen
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osteogenesis imperfecta
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"brittle bone disease"
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osteogenesis imperfecta
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has a congenita and tarda form.
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osteogenesis imperfecta
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3 criteria for dx are:
1) osteoporosis w/abnormal skeletal fragility 2) blue sclera of eye 3) abnormal teeth (small, misshapen, discolored) |
osteogenesis imperfecta
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hallmark is multiple fractures
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osteogenesis imperfecta
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anemia is hallmark
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osteopetrosis
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AKAs of osteopetrosis.
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1) Albers/Schonberg disease
2) "marble bone disease" |
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overgrowth and sclerosis of bone. Greatly thickened cortex with decrease or elimination of marrow cavity
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osteopetrosis
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failure of osteoclastic resorption. Persistance of primitive calcified cartilage.
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osteopetrosis
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hepatosplenomegaly
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osteopetrosis
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hemorrhage is most frequent cause of death
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osteopetrosis
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xray shows widespread homogenous increase in bone density
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osteopetrosis
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A disturbance of normal endochondral growth and maturation of cartilage at the physis.
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Achondroplasia
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congenital and recognized at birth
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achondroplasia
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most common form of dwarfism
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achondroplasia
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limbs are short and spine relatively normal in length
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achondroplasia
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"rhizomelia"
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achondroplasia
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large cranium with prominent forehead
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achondroplasia
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protruberant abdomen and buttocks
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achondroplasia
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posterior pelvic tilt and angulation of hip joint
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achondroplasia
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rolling gait
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achondroplasia
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increased height of IVDs
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achondroplasia
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decreased space b/t pedicles
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achondroplasia
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most common complication is congenital spinal stenosis wich may lead to paraplegia.
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achondroplasia
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