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30 Cards in this Set

  • Front
  • Back
increased porosity d/t decr in bone mass
-prognosis: pulm embolism, pneumonia
1. Age Related (Senile osteoporosis):
-low turnover
-osteoblasts from old ppl havce reduced biosynthetic potential

2. Postmenopausal Osteoporosis
-high turnover
-decr estrogen-->incr cytokines that attract osteoblasts
Paget's dz
-MC site?
-incr osteoclastic and osteoblastic activity with ABNL bone formation
-MC site: axial skeleton and prox femur
-incr serum alk phos (d/t incr bone turnover)
-Sx: bowing of femur
end result: coarsely thickened trabeculae and cortices that are soft and porous-->FRACTURES!
1. osteolytic
2. mixed osteolytic/osteoblast
3. osteoblastic
4. quiescent osteosclerotic

-adjacent marrow hypervascular
-mosaic cement lines
bowing of femur
Paget's dz
incr serum alk phos
Paget's dz
mosaic cement lines
Paget's dz
pathologic fracture
bones already altered by dz process
stress fracture
slowly developing incr fracture after incr exercise
bone healing
soft callus (procallus):
hematoma-->influx of inflam cells-->fibroblasts (make collagen)-->new capillary vessels-->activate osteoprogenitor cells-->osteoclastic and osteoblastic activity

Bony callus:
-subperiosteal formation of woven bone
-trabeculae perpendicular to cortical axis
trabeculae perpendicular to cortical axis
bony callus formation
what causes pseudoarthrosis
cystic degeneration of non-union callus with synovial-like lining
non-union callus
abnl bone healing
-callus composed of fibrous tissue adn cartilage (unstable)

-cystic degen of non0union callus-->pseudoarthrosis
avascular necrosis
-bone necrosis secondary to ischemia
-also sickle cell anemia

1.medullary infarcts: involve cancellous bone (cortex not affected d/t collateral blood flow)
*no pain, rarely becomes malignant

2. subcortical infarct: wedge-shaped, overlying cartilage is viable
*chronic pain,
-->>severe osteoarthritis

3. dead bone: "creeping substitution" (resorption of dead bone with new bone formation)
medullary infarct
involve cancellous (AKA spongy AKA trabecular) bone (cortex not affected d/t collateral blood flow)

*no pain, rarely becomes malignant
subcortical infarct
wedge-shaped, overlying cartilage is viable

*chronic pain,
-->>severe osteoarthritis
creeping substitution
-what is it?
-in what condition do we see it?
resorption of dead bone with new bone formation)

-seen in avascular necrosis
pyogenic osteomyelitis:
-caused by:
*Staph Aureus (MC)
*Salmonella in sickle cell dz=EXAM

-spread hematogenously

neonates: metaphysis+epiphysis
children: metaphysis
adults: epiphysis

Path: dead bone (sequestrum) srurrouded by sleeve of reactive bone (involucrum)

-Brodie's abscess=small intracortical abscess

Path: acute inflam-->bone necrosis-->osteoclasts resorb bone-->ingrowth of fibrous tissue-->BM elements disappear-->reactive bone in periphery

X-ray: lytic focus surrounded by sclerosis

prognosis: get endocarditis or SCC
characteristic X-ray: lytic focus surrounded by sclerosis
pyogenic osteomyelitis
endocarditis assoc w/
pyogenic osteomyelitis
SCC in sinus tract in long stnading draining sinuses assoc w/
pyogenic osteomyelitis
tuberculous osteomyelisis: site?
spine ("pott's dz")
Pott's dz
-what is it?
-assoc with what dz?
-involves the SPINE
-assoc w/tuberculous osteomyelitis
MC joint dz?
progressive erosion of articular cartilage
osteoarthritis (vs. RA-erosion of BONE)
-assoc w/what dz?
eburnation=no cartilage
-assoc w/OA
"joint mice"
subchondral cysts
Herberden's nodes
"rice bodies"
RA (Rice=RA)
rheumatoid nodules look like
central fibrinoid necrosis, surrounded by histocytes+mononuclear cells