Bone Path Flashcards
What is Focal Osteoporotic Marrow defect?
When an area of hematopoeitic marrow is seen in the jaw.
Pathogenesis unknown
How is Focal osteoporotic marrow defect discovered?
It’s Asymptomatic
Discovered as an incidental finding on radiographic examination.
What does focal osteoporotic marrow defect look on radiograph?
It is seen as a radiolucent lesion with no expansion.
What is the prevalence of gender and location?
75% of cases occur in women
70% of cases occur in the posterior mandible, usually in an edentulous area
What would be the histological features for focal osteoporotic marrow defect?
Cellular hematopoietic and/ or fatty marrow
Treatment and prognosis for focal osteoporotic marrow defect?(4)
Incisional biopsy to establish a diagnosis
No treatement after diagnosis has been made
Prognosis is excellent
No association with hematologic disorders.
What is Pagets disease of bone?
Characterized by abnormal Resoprtion and Deposition of bone causing distortion and weakening of the affected bones.
What is pagets disease also known as?
Osteitis deformans
What is the etiology of Pagets disease of bone
Cause is unknown Inflamatory genetic endocrine slow virus(paramyovirus)
What is the typical patient for pagets disease of bone?
Older patients
Rare under 40 years of age
M>F
I believe she said shes never had a patient with this that wasnt male
What are the clinical forms of Pagets disease of bone?
Monostotic: single bone
Polystotic: multiple bone involvement
The most commonly affected bones of Pagets disease of bone? (5)
Pelvis Skull Femur Lumbar vertebrae Tibia
What are the oral and skull manifestations?
Increased circumference of the head
MX>MD
Marked facial deformity:leontiasis ossea
What are some clinical features you might see with a patient with Pagets disease of bone?(7)
Nasal obstruction Enlarged turbinates Obliterated sinuses Deviated septum Alveolar ridges are grossly enlarged Spacing between teeth Dentures no longer fit
ANODDES
What are the Radiographic features of Paget’s disease of bone called?
Early stage: osteoclastic phase
Late stage osteoblastic phase
What is seen in the early and late stages of pagets disesase of bone radiographically?
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
What are the histoogical features of PDOB
prominent osteoblastic and osteoclastic activity surrounding the bone trabeculae
Resting and reversal lines: jigsaw puzzle or mosaic patter. vascular vibrous CT replaces the marrow.
What is seen in the diagnosis of pagets?(2)
Increased serum alkaline phosphatase
Normal blood calcium and phosphorus
Treatment and prognosis of PDOB
Bisphosphonate therapy: reduces bone turnover and normalizes alkaline phosphatase levels
Analgesics and NSAIDs
New and larger dentures
What is a rare but deadly development in PDOB?
Osteosarcoma: develops in 1% or less of cases and usually in the pelvis and long bones
Very aggressive, poor prognosis
