Bone Disorders Flashcards
Heterotopic ossification (HO)
Formation of trabecular bone in a location in the body where it does not normally exist
Causes of Heterotopic ossification
Truama Burns/wounds TBI/SCI Spasticity Hip dislocation Inflammatory myopathies Parathyroid d/o Vitamin D excess Immobilization
Myositis ossificans
HO due to trauma at a single site
Myositis ossificans progressive (MOP)
Rare, severely disabling, autosomal dominant HO with variable expressivity
Dx of Heterotopic ossification
3-phase bone scan
CT scan
CBC, ESR, Alk phos
Tx of Heterotopic ossification
NSAID
Bracing
Etidronate in adults
Legg-Calve-Perthes Dz
Avascular necrosis of the hip in children
Legg-Calve-Perthes Dz Clinical features
Walks with antalgic limp
Pain in groin, knee and thigh over weeks to mo
Muscle spasm around hip
Slipped Capital Femoral Epiphysis (SCFE)
MC adolesecen hip d/o
Displacement of femoral epiphysis on he metaphysis
Epidemiolgy of SCFE
Males MC
Black and Hispanic
Peak age 13 (male), 11 (female)
Bilateral 25% of time
Risk factors of SCFE
Renal osteodytrophy Radiation Down Syndrome Obesity Hypothyroidism Hypopituitarism Rickets
History of SCFE
Sudden onset of pain without trauma Chronic pain over weeks l/t limp Inability to ext or IR Refusal to bear wt Out toed gait Abductor lurch
Exam of SCFE
Loss of IR of hip
Pain with ext and IR
ER and flexed foot
Abductor lurch
Pelvis drops in single leg stance, then trunk shifts toward side to with hip abductor weakness to compensate
Transient Synovitis of the Hip
Idiopathic benign inflammation of the joint
Often seen in children w/ recent URI
Transient synovitis of the hip CF
Unilateral knee, hip or thigh pain
Duration days to weeks
Refusal to bear wt
ADD and IR of leg elicit pain
Osteogenesis Imperfecta
Heritable d/o of ABN bone quality or quantity
Defect in Osteogenesis Imperfecta Types I-IV
Type I collagen
Defect in Osteogenesis Imperfecta Types V-VIII
Normal collagen
Other genetic mutations
Inheritance of Osteogenesis Imperfecta
Autosomal dominant
Osteogenesis Imperfecta CF
Fractures: few to hundreds Sclerae blue to gray Short stature w/ more fractures Relative macrocephaly Conductive hearing loss Scoliosis
Osteogenesis Imperfecta Tx
Bisphosphonates
Growth hormone
Primary Osteoporosis
Bone loss associated with loss of estrogen or aging
MC type
Secondary Osteoporosis
Bone loss associated w/ other conditions
