Dougherty Part 2 Flashcards
what is rickets
child vitamin D deficiency
osteomalacia is what
adult vitamin D deficiency
hyperparathyroidism is due to what
PTH excess
renal osteodystrophy is due to what
chronic renal disease
primary hyperparathyroidsim is most commonly from what
an adenoma
in hyperparathyroidism what is the osteoclast and osteoblast activity
increased activity in both OC>OB
secondary hyperparathyroidism is often due to what
hypocalcemia
what is part of the skeleton is affected in hyperparathyroidism
entire skeleton
what is seen in osteitis fibrosa cystica
subperiosteal resorption thins cortices
loss of lamina dura around the teeth
X-ray: bone loss radial aspect of middle phalanges of index and middle finger/ osteopenia
what is a brown tumor
bone replaced by fibrovascular tissue
microfractures result in hemorrhage and healing
granulation tissue and hemosiderin
what bone disease is caused by hyperparathyroidism
osteitis fibrosa cystica
brown tumors are seen in what
hyperparathyroidism (osteitis fibrosa cystica)
in renal osteodystrophy what is the osteoclast and osteoblastic activity
increased or decreased
in renal osteodystophy what is going on
hyperparathyroidism
decreased vitamin D conversion to 1,25-OH2VitD3
metabolic acidosis (increase release of calcium)
mosaic pattern of lamellar bone (jigsaw puzzle-like cement lines) is seen in what
paget disease (osteosclerotic
what are the stages of paget disease
osteolytic stage- loss of bone mass
mixed stage- osteolytic and osteoblastic
osteosclerotic stage- coarse thick irregular trabecular
v-shaped “blade of grass” lesion is characteristic of what
lytic pause of page’s disease
chalk stick-type fracture is seen in what
paget disease
what are calcium and phosphate levels in paget disease
normal
in paget disease what are alkaline phosphate levels
high
what benign tumors are associate with paget disease
giant cell tumor
giant cell reparative granuloma
extraosseous hematopoeisis
what malignant tumors are associate with paget disease
osteosarcoma
fibrosarcoma
how does one treat paget disease
calcitonin and biphosphonates
what is a soft tissue callus (procallus)
hematoma fibrin creates framework
influx inflammation, fibroblasts, and capillaries
osteoprogenitor cells activated
no rigidity, easily disrupted
boney callus is what
woven bone is made
+/- cartilage for enchondral ossification
over time remodels to bear full weight
when is the maximum girth of a callus
3 weeks
what are some complications with fractures
misaligned bone
infected, displaced or devitalized bone leads to deformity
pseudoarthrosis: nonunion
what is the most common cause of osteonecrosis
corticosteroids
what is osteonecrosis
infarction of bone and marrow
dead bone/fat is replaced by calcium soaps
what are some of the most common causes of avascular necrosis
corticosterioids infection dysbarsim (bends) pregnancy sickle cell disease and other anemias
avascular necrosis due to subchondral infarct can be easily recognized in a photograph by what
crack in the bone
avascular necrosis due to a medullary infarct casuses what
geographic necrosis
small silent and stable
large painful (dysbarism, sickle cell)
avascular necrosis due to subchondral infarct causes what
chronic pain
wedge-shaped subchondral bone (often crack beneath preserved cartilage, overlying cartilage nurtured by synovial fluid)
secondary collapse lead to osteoarthritis
what is osteomyelitis
inflammation almost always from infection
how do bacteria reach the bone in osteomyelitis
hematogenous (most common in children)
direct extension
implantation
what is the classic x-ray seen in osteomyelitis
lytic bone lesion with surrounding sclerosis
what is the most common cause of pyogenic osteomyelitis
staph aureus
what causes pyogenic osteomyelitis in people with GU infection and IV drug users
E Coli
pseudomonas
klebsiella
pyogenic osteomyelitis in infants is commonly caused by what
H. flu
Group B strep
what location is influenced by blood supply in pyogenic osteomyelitis of a neonate
metaphysis and or epiphysis (can spread into join through articular surface or adjacent structures)
what location is influenced by blood supply in pyogenic osteomyelitis of a children
metaphysis (subperiosteal abscess)
what location is influenced by blood supply in pyogenic osteomyelitis of an adult
epiphysis and subchondral bone
what is sequestrum and when is it seen
dead piece of bone
pyogenic osteomyelitis
what is involucrum and when is it seen
reactive surrounding bone
pyogenic osteomyelitis
what is sclerosing osteomyelitis of Garre
in jaw with extensive new bone formation
what are complications of chronic osteomyelitis
pathologic fracture
sarcoma
how does osteomyelitis present
acutely sick to unexplained fever
local pain
draining sinus (can develop squamous cell carcinoma)
what is potts disease
TB osteomyelitis of the lumbar/thoracic spine
break through discs to other vertebrae (scoliosis and kyphosis)
most common TB osteomyelitis
potts disease
what causes syphilis of the bone
T pallidum and T pertenue (yaws)
what is seen in acquired syphilis of the bone
involves bone in tertiary phase
SADDLE NOSE
palate
skull
