bones 1/22

Question 1

• condition resulting in soft bones which typically bow and fracture more easily than normal bone
• results from either a dietary deficiency or poor absorption of calcium and/or phosphate
• associated medical conditions (e.g., celiac, kidney or liver disease), surgery (e.g., gastrectomy)
• associated w use of some prescription medications (e.g., phenobarbital).

Answer 1

Osteomalacia

Question 2

• increased bone mass, but notable fragility resulting from significantly decreased osteoclast activity.
• Pathologic fractures are common
• genetic autosomal dominant trait

Answer 2

adult onset form of osteopetrosis, “stone bone”, marble bone disease, Albers-Schönberg disease,
(infantile and intermediate forms inherited as autosomal recessive traits)

Question 3

• in pediatric population associated with pathological fractures
• incidence of the condition is low and typically occurs secondary to another medical condition (e.g., malignancy), trauma (e.g., severe burn), long-term medication use (e.g., corticosteroids) or severe dietary deficiencies (e.g., calcium, vitamin D).

Answer 3

Osteoporosis

Question 4

• genetic condition which causes abnormality in type I collagen synthesis.
• patient bruises easily and has a lifelong history of pathological fractures
• autosomal dominant

Answer 4

Osteogenesis imperfecta, types I and IV, Milder presentations

Question 5

• genetic condition which causes abnormality in type I collagen synthesis.
• patient bruises easily and has a lifelong history of pathological fractures
• autosomal recessive traits

Answer 5

Osteogenesis imperfecta, types II and III, more severe forms

Question 6

what pathology?

• Proper handling techniques are critical to the integrity of these patients’ bones since fractures are extremely common.
• Patients will have bowing of long bones, a barrel shape of their rib cage, possible hearing loss, brittle teeth, and near normal sclera.

Answer 6

type IV osteogenesis imperfecta

Question 7

wedge vs burst fracture?

common cause?

Answer 7

cause - external force on spine (eg. fall, carrying heavy weight, severe forward bend), the forces exceed the ability vertebral body bone to support the load
wedge, compression fracture - anterior vertebral body crush forming a wedge shape
burst - entire vertebral body breaks

Question 8

what spinal movement are compression/wedge fractures associated with?
what muscles should be stretched?

Answer 8

flexion
stretch antagonistic muscles -
- Shoulder- horizontal adductors, medial (internal) rotators
- Hip- flexors, medial (internal) rotators