Bone Path

Question 1

What is Focal Osteoporotic Marrow defect?

Answer 1

When an area of hematopoeitic marrow is seen in the jaw.

Pathogenesis unknown

Question 2

How is Focal osteoporotic marrow defect discovered?

Answer 2

It’s Asymptomatic

Discovered as an incidental finding on radiographic examination.

Question 3

What does focal osteoporotic marrow defect look on radiograph?

Answer 3

It is seen as a radiolucent lesion with no expansion.

Question 4

What is the prevalence of gender and location?

Answer 4

75% of cases occur in women

70% of cases occur in the posterior mandible, usually in an edentulous area

Question 5

What would be the histological features for focal osteoporotic marrow defect?

Answer 5

Cellular hematopoietic and/ or fatty marrow

Question 6

Treatment and prognosis for focal osteoporotic marrow defect?(4)

Answer 6

Incisional biopsy to establish a diagnosis
No treatement after diagnosis has been made
Prognosis is excellent
No association with hematologic disorders.

Question 7

What is Pagets disease of bone?

Answer 7

Characterized by abnormal Resoprtion and Deposition of bone causing distortion and weakening of the affected bones.

Question 8

What is pagets disease also known as?

Answer 8

Osteitis deformans

Question 9

What is the etiology of Pagets disease of bone

Answer 9

Cause is unknown
Inflamatory
genetic
endocrine
slow virus(paramyovirus)

Question 10

What is the typical patient for pagets disease of bone?

Answer 10

Older patients
Rare under 40 years of age
M>F

I believe she said shes never had a patient with this that wasnt male

Question 11

What are the clinical forms of Pagets disease of bone?

Answer 11

Monostotic: single bone
Polystotic: multiple bone involvement

Question 12

The most commonly affected bones of Pagets disease of bone? (5)

Answer 12

Pelvis
Skull
Femur
Lumbar vertebrae
Tibia

Question 13

What are the oral and skull manifestations?

Answer 13

Increased circumference of the head
MX>MD
Marked facial deformity:leontiasis ossea

Question 14

What are some clinical features you might see with a patient with Pagets disease of bone?(7)

Answer 14

Nasal obstruction
Enlarged turbinates
Obliterated sinuses
Deviated septum
Alveolar ridges are grossly enlarged
Spacing between teeth
Dentures no longer fit

ANODDES

Question 15

What are the Radiographic features of Paget’s disease of bone called?

Answer 15

Early stage: osteoclastic phase

Late stage osteoblastic phase

Question 16

What is seen in the early and late stages of pagets disesase of bone radiographically?

Answer 16

Early osteoclastic phase: radiolucent, Osteoporosis circumscripta
Late stage osteoblastic phase: sclerotic areas, cotton wool appreance. May resemble florid cemento osseous dysplasia.
hyper cementosis only in a single tooth in pagest

Question 17

What are the histoogical features of PDOB

Answer 17

prominent osteoblastic and osteoclastic activity surrounding the bone trabeculae
Resting and reversal lines: jigsaw puzzle or mosaic patter. vascular vibrous CT replaces the marrow.

Question 18

What is seen in the diagnosis of pagets?(2)

Answer 18

Increased serum alkaline phosphatase

Normal blood calcium and phosphorus

Question 19

Treatment and prognosis of PDOB

Answer 19

Bisphosphonate therapy: reduces bone turnover and normalizes alkaline phosphatase levels
Analgesics and NSAIDs
New and larger dentures

Question 20

What is a rare but deadly development in PDOB?

Answer 20

Osteosarcoma: develops in 1% or less of cases and usually in the pelvis and long bones
Very aggressive, poor prognosis