Bone disorders Flashcards
What are the symptoms of osteoarthritis?
Pain and crepitus when moving
Background ache
Worse with prolonged activity
Perceived joint weakness
What X-ray changes are shown in osteoarthritis?
LOSS Loss of joint space Osteophytes Subarticular sclerosis Subchondral cysts
Slightly raised CRP
How is osteoarthritis treated?
Exercise and weight loss
Paracetamol and short term/topical NSAIDs
Steroid injections
Joint replacement
What are risk factors for osteoporosis?
Steroid use, female, older, low BMI, alcohol, menopause
What do investigations for osteoporosis show?
DEXA - low density
Normal Ca, ALP and phosphate
How is osteoporosis managed?
Lifestyle - stop smoking, reduce alcohol, balance exercises, Ca and VitD in diet
Bisphosphonates (alendronic acid), Ca and VitD,
What are the causes of osteomalacia?
Vitamin D deficiency/resistance Renal osteodystrophy Drugs - anti-convulsants Liver disease Tumour induced
What are the symptoms of osteomalacia?
Rickets - poor growth, hypotonia, apathy, bow-legged/knock knees
Bone pain, fractures, proximal myopathy (waddling gait)
What do investigations for osteomalacia show?
Low Ca, phosphate, VitD,
high ALP, PTH
Biopsy - incomplete bone mineralisation
X-ray - loss of cortical bone
How is osteomalacia treated?
Dietary cause - VitD (calcium D3 forte tablet)
Malabsorption/hepatic cause - D2 (ergocalciferol)
Renal/resistant cause - Alfacalcidol
Monitor Ca levels weekly and if any vomiting
What causes Paget’s disease?
Increased bone turnover
Bone remodelling
Increased osteoblasts and clasts
What are the symptoms of Paget’s disease?
Bone enlargement, deformity and weakness - pelvis, lumbar spine, skull, femur, tibia
Bone pain
What do investigations for Paget’s disease show?
X-ray - enlargement, cortical thickening, sclerosis, osteolysis, deformity
Normal Ca and phosphate, high ALP
How is Paget’s disease treated?
Analagesia
Alendronic acid
What are the signs of renal osteodystrophy?
Osteopenia Salt and pepper skull Brown tumours Subperiosteal erosions Pseudo#s Rugger-jersey spine
