Bone Disorder Pathology Flashcards
Labs for osteoporosis
all normal
Labs for osteopetrosis
all normal
maybe decreased calcium in severe malignant disease
Labs for Paget Disease
increased ALP
look for mosaic pattern of bone architecture
Labs of primary hyperthyroidism
increased calcium
decreased phosphate
increased ALP
increased PTH
Labs of secondary hyperthyroidism (CKD)
decreased calcium
increased phosphate
increased ALP
Increased PTH
Labs of Vitamin D Deficiency
decreased calcium and phosphate
increased ALP and PTH
Labs of Hyper Vitamin D
increased calcium and phosphate
normal ALP
decreased PTH
Associations of Osteoporosis
Polymorphisms in RANK, RANKL and OPG
Estrogen deficiency
pathologic fractures
reduced proliferation of osteoblasts/ increased proliferation of osteoclasts
DEXA
Osteopenia
DEXA
Osteoporosis
Clinical presentation of osteoporosis
pathologic fractures
back pain secondary to vertebral compression
decreased height
thoracic hyperkyphosis
Osteoporosis treatments
increase calcium bisphosphonates PTH analogs Raloxifene Denosumab Estrogen Increased activity
Associations of Paget disease
Men > women
modulation of Vitamin D sensitivity and ILS secretion by virally infected osteoclasts
Pathology of Paget Disease
Increased RANK/ RANKL activity and NK-kB signaling
Increased osteoclast activity yielding increased osteoblast activity, creating disorganized woven bone
Morphology of Paget Disease
deformed bones with sclerotic and osteolytic lesions
thickened cortical bone with coarsened trabeculae
cotton wool appearance on skull XR- Lion face
Disruption/ fusion of sacroiliac joints
Clinical presentation of Paget Disease
increased skull size bone pain bony deformities cranial nerve deficits chalk stick pathologic fractures of long bones
Treatment of Paget Disease
Bisphosphonates
Calcitonin Therapy
Vitamin D + Calcium
NSAIDs
Morphology of Vitamin D deficiency
Thin cortices
Pseudofractures/ looser zones of transverse bands with radiolucency, indicating defective calcification of osteoid
growth plates in long bones are less defined and show cupping/ stippling/ fraying
Clinical Presentation of Vitamin D deficiency
bone pain pathologic fractures waddling gait muscle weakness muscle spasms bone deformities
what causes avascular necrosis
corticosteroids alcoholism sickle cell trauma decompression disease (the bends) Gaucher Disease
