Bone Disorders Flashcards
Osteoporosis Rickets nad Osteomalacia Paget Disease(Osteitis Deformans) Osteomyelitis Abnormal Curvatures of the Spine Bone Tumors
The early stages of Osteoporosis are:
asymptomatic
How can a microorganism that causes Osteomyelitis enter the blood and reach the bones?
from an infection anywhere in body - spread to bones
can also occur as a result of surgery, particularly when a pin or structural insert is involved
What is Vitamin D required for?
absorption of calcium
Specific cause of: Lordosis
achondroplasia
obesity
discitis
slipping forward of the vertebrae
Signs and Symptoms - Osteoporosis:
Compressions fractures of the vertebrae have several obvious effects.
Back pain - associated with altered vertebrae = pressure on nerves
Kyphosis and scoliosis
accompanying loss of height
spontaneous fractures involving head of femur or pelvis frequent
healing of fractures is slow.
Treatment for abnormal curvatures of the spine:
medication for pain relief and inflammation
weight loss
wearing a brace
exercise and physical therapy
surgery
various nontraditional forms tx, e.hg. chiropractic, nutritional therapy, acupuncture
What are ther goals of Tx in Paget’s disease?
reduce the risk of fractures and deformity
What are two common causes of the three types of abnormal spine curvature?
Osteoporosis
Arthritis
but other causes are specific to individual spine curvature disorders, these abnormalities can develop during adolescence
Therapeutic measures for Osteoporosis:
Calcium and VitD
Fluoride Supplements - promote bone deposition
Bisphosphonates e.g. alendronate (Fopdsomax) short-term option inhibit osteoclast activity and bone resorption
Calcitonin (miacalcin nasal spray)
Injected human parathyroid hormone to decrease bone reabsorption (helpful for some individuals)
Regular weight-bearing exercise program such as walking or weight-lifting
Raloxifene (Evista) or tamoxifen, classed as a selective oestrogen receptor modulator drugs; recommended specific cases as there is less effect on uterine and breast tissue (use of oestrogen replacement therapy for osteoporosis questioned due to risk cancer)
Surgery to reduce kyphosis and realign the vertebral column
What other diseases can Paget’s disease cause?
cardiovascular disease and heart failure
Scoliosis
either S-C shaped sideways curve to the spine
Signs and Symptoms of Osteomyelitis:
as with any infection, be local and systemic manifestations
local inflammation and bone pain
fever and excessive sweating
chills
general malaise
What fractures are common in Paget’s disease?
Pathologic
What is Paget’s disease also known as?
Osteitis Deformans
What is secondary osteoporosis?
follows specific primary disorder e.g. Cushing syndrome
What does “Renal Rickets” refer to?
osteomalacia associated with severe renal disease
What is Osteomyelitis?
bone infection usually caused by bacteria and sometimes fungi
Specific cause of: Scoliosis
specific cause or most common form - unknown
however tends run in families and some general causes e.g. disease, trauma, congenital defecets beleived to be implicatd
What is Osteoporosis characterised by?
decreased bone mass, density
with loss of bone matrix and mineralisation
Difference between Osteomalacia and Rickets?
Adults - osteomalacia
Children - rickets
What does a lack of calcification of cartilage forming at the epiphyseal plate lead to?
weak bones
deformities
typical “bow legs” (rickets)
the child’s height is usually below normal
What may happen when abnormalities to the curvature of the spine occur?
curves misaligned or exaggerated = three main curvature disorders
What results if Paget’s disease has affected the Skull?
signs of increased pressure e.g. headache, compression of cranial nerves
Tx - Osteoporosis:
Usually, bone cannot be restored to normal structural levels, but therapy can retard further bone loss. In addition to treating any underlying problem, therapeutic may be used.
What can a deficit of Vit D and phosphates required for bone mineralisation result in for children?
soft bones
rickets
Kyphosis
‘hunchback’, ‘humpback’
abnormally rounded upper back
Specific cause of: Kyphosis
poor posture spina bifida congenital defects spinal tumours or infections Scheuermann disease
What is Osteomalacia?
occurs in adults
poor absorption of Vit D or sometimes calcium causes:
soft bones
resulting in compression fractures
What is primary osteoporosis?
postmenopausal, senile, idiopathic osteoporosis
What are the two forms of Osteoporosis?
primary
secondary
True or False?
In some cases is Paget’s disease asymptomatic.
True
Predisposing Factors for Osteoporosis:
Ageing
Decreased mobility/ Sedentary lifestyle
Hormonal Factors e.g. hyperparathyroidism, Cushing syndrome, continued intake catabolic glucocorticoids e.g. prednisone
Deficits calcium, vitD, protein diet/ Hx deficits - childhood or malabsorption disorders
Cigarette smoking
Small light bone structure - asian, caucasian
excessive caffeine intake
What Osteoporosis?
common metabolic bone disorder
What is the purpose of the curves formed by the vertebrae?
help spine sbsorb stress of movement and action of gravity
Pathophysiology Osteoporosis:
during the continuous bone remodelling process
bone resorption exceeds bone formation =
thin, fragile bones
that are subject to spontaneous fracture, esp vertebrae
although bone density and mass reduced, remaining bones are normal
osteoporosis affects the bones consisting of higher proportions of cancellous bone, e.g. vertebrae and femoral neck
Lordosis
‘swayback’
spine curves significantly inward at the back
What is seen on X-rays of those with Paget’s disease?
structural abnormalities
enlargement (or thickening) apparent in long bones, vertebrae, pelvis and skull
Dx Osteoporosis:
bone density scans
x-rays to demonstrate bone change
What new methods of treatment are being researched for Osteoporosis?
New methods to stabilise bones and prevent fractures
At what age does bone mass generally peak?
young adults then gradually decline depending on genetic factors (Vit D receptors)
nutrition
weight-bearing activity
hormonal levels
calcium intake as a child and young adult - critical to the maintenance of bone mass later in life
What is Paget’s disease?
progressive bone disease
older than 40 years
excessive bone destruction occurs with replacement of bone by fibrous and abnormal bone
What do the conditions Rickets and Osteomalacia result from?
a deficit of Vit D and phosphates required for bone mineralisation
occurs with dietary deficits malabsorption prolonged intake of phenobarbital (for seizures) lack of sun exposure
Why is Decreased mobility/ Sedentary lifestyle a predisposing factor of Osteoporosis?
mechanical stress on bone by muscle activity is essential for osteoblastic activity
decreased mobility is a factor with ageing, but it can also occur if a patient is on bed rest
one limb or area of the body may be affected by osteoporosis when it is immobilised because of conditions such as a fracture
What is the cause of Paget’s disease?
cause not yet est, but childhood infection with virus implicated and evidence of genetic factoprs
What is Rickets?
Rickets - affects bone development in children
causes bone pain, poor growth and soft, weak bones that can lead to bone deformities
What results if Paget’s disease has affected the vertebrae?
compression fractures
kyphosis
Why is Age a predisposing factor of Osteoporosis?
osteoporosis is common in older individuals, esp postmenopausal women with estrogen deficiency
osteoblastic activity is less effective with advancing age
Treatment of Osteomyelitis:
antibiotics
infection prolonged, significant damage bone - surgery remove, repair damage tissue
if insert or mechanical implant involved - surgery to remove the device
