Bone Diseases

Question 0

What is the cause of osteopetrosis?

Answer 0

Defect in carbonic anhydrase enzyme in osteoclasts

Question 1

What is osteopetrosis?

Answer 1

Scleorsis of the bone leading to marble bone

Question 2

What can happen to the cranial base in osteopetrosis and what effect does this have ?

Answer 2

Increased deposition can compress the cranial nerves

Question 3

What are the systemic signs of osteopetrosis?

Answer 3

Anaemia and pathological bone fractures

Question 4

What are the radiological signs of osteopetrosis?

Answer 4

-Uniformly dense radiopaque skull vault -narrowing of nerve foramina -thickening of the lamina dura in jaw -delayed tooth eruption IF JAW IS INVOLVED ALWAYS BILATERAL

Question 5

What are the radiological features of hyperparathyroidism?

Answer 5

Osteopenia (decreased density): very fine ground glass trabecular pattern/salt and pepper Bone pain Browns tumours Loss of lamina dura around all teeth Loss of the thick border of mandible

Question 6

What can people with hyperparathyroidism get in the long bones?

Answer 6

Following severe chronic skeletal hyperparathyroidism this can lead to OFC which is when the cyst degenerates and forms fibrous tissue

Question 7

What are thr cysts in browns tumour composed of?

Answer 7

Lined by osteoclasts and sometimes blood pigments hence why they are brown

Question 8

Which blood dyscrasia scan affect the bone?

Answer 8

Anemia and thallaseemia

Question 9

How can sickle cell anaemia present radiologically?

Answer 9

Hair on end appearance of skull Hyperplasia of bone marrow spaces at the expense of cancellous bone Course trabecular pattern and step ladder appearance of the bone between the roots of teeth occurs Enlargement of the maxilla Normal lamina dura Boney infarcts

Question 10

What is thalassemia?

Answer 10

Mainly seen in Greeks Abnormal beta chain synthesis so RBC have short life span

Question 11

What are the radiological signs of thalassemia?

Answer 11

Large marrow spaces Encroachment into the antral spaces Thining of cortical structures mainly lower border of mandible Shorted teeth or spiked shapes NO BONE INFARCT

Question 12

What is Paget’s disease ?

Answer 12

Disease of the elderly where normal process of bone deposition and resorption are disrupted

Question 13

What part of the body is spared in Paget’s?

Answer 13

Hands and feet

Question 14

What are the two stages of Pagets?

Answer 14

Earlier stage: bone resorption Late stage: bone deposition

Question 15

What are the main features of Paget’s?

Answer 15

Haphazard sclerotic bone cotton wool appearance Enlargement of the skull Loss of lamina dura

Question 16

What is this?

Answer 16

Pagets disease of the bone

Question 17

What is this?

Answer 17

Pagets disease of the bone

Question 18

What is this disease?

Patient presents with delayed tooth eruption and acute psudomembranous candidiasis?

Answer 18

Osteopetrosis

Question 19

What is this disease?

Answer 19

Hyperparathyroidism is the skull picture

Browns tumour of hyperparathyroidism

Question 20

42 year old male from Greece, comes to you at your practice for an extraction of multple teeth prior to chemotherapy. You take the DPT, what do you notice?

Answer 20

Thallassemia

spiky teeth, enlarged marrow spaces, encroachment into antrum

Question 21

What disease could this be?

Answer 21

Thallassemia or anemia

In thallassemia would also see root resprotion and no evidence of bone infarcts, and usually in meditteranean people

In anemia usually in tropical countries eg Africans and see bone infarcts and step ladder appaearance of trabecular bone between teeth