Fractures, Osteonecrosis, Osteomyelitis

Question 1

Stress fracture

Answer 1

Bone fractures after repeated stress

Question 2

Incomplete fracture

Answer 2

Bone is not broken all the way across, still in one piece. The prototype is a Greenstick fracture which happens in young babies with fragile bones

Question 3

Simple fracture

Answer 3

overlying tissues are intact

Question 4

SImple complete

Answer 4

overlying tissues are intact and the bone is broken all the way across.

Question 5

Compound fracture

Answer 5

bone has pierced the skin/ bacteria have a route to get into the body.

Question 6

complex fracture

Answer 6

the opposite of simple…bones have done serious damage to overlying tissue

Question 7

Pathologic fracture

Answer 7

fracture due to a force that would not break a normal bone

Question 8

Where does osteonecrosis most commonly take place in the bone?

Answer 8

Convex surface of joints

Question 9

What is the most feared result when bone tissue is dying near the convex surface of a joint?

Answer 9

detachment of the articular cartilage

Question 10

What are the risk factors for osteonecrosis

Answer 10

• sickle cell disease
• decompression sickness: bubbles form clots, the bends in the bones
• Femoral neck fracture or dislocation
• Alcohol abuse- dont know why
• gluccocorticoid use- dont know why

Question 11

One of the most common features of sickle cell crisis

Answer 11

is bone pain. Painful bone infarcts that can result in osteonecrosis

Question 12

What is the normal cellularity in marrow?

Answer 12

50% cells and 50% fat

Question 13

In sickle cell, bone marrow becomes hypercellular. Remember that bone marrow is generally 50% cells and 50% fat. In sickle cell it is almost 100% cells. This hypercellularity interferes with normal blood flow and can lead to infarct and necrosis

Answer 13

ok

Question 14

Osteomyelitis

Answer 14

bone infection

Question 15

Most frequent cause of osteomyelitis

Answer 15

pyogenic organisms. Develops by hematogenous spread or in pts with poor wound healing (vascular insufficiency).

Question 16

Hematogenous osteomyelitis is most common in who?

Answer 16

Children 2-5 yo

Question 17

Risk factors for osteomyelitis?

Answer 17

diabetes, orthopaedic surgery, adjacent infection, peripheral vascular disease, siclkle cell disease, congenital phagocytic function

Question 18

Why is hematogenous osteomyelitis most common in 2-5 yo kids?

Answer 18

Because as long bones grow (remember they grow from the endochondral growth plate) they need heavy blood supply so infection is more likely to spread

Question 19

Most cases of osteomyelitis are due to what type of bacteria

Answer 19

pus forming (pyogenic), more specificallly STAPH

Question 20

Where does osteomyelitis generally begin in the bone?

Answer 20

Metaphysis (growth plate region)

Question 21

In sickle cell disease, what type of bacteria often forms osteomyelitis

Answer 21

Salmonella…KNOW

Question 22

What is Pott’s Disease

Answer 22

Tuberculosis osteomyelitis specifically in the vertebral column. Leads to collapse of the vertebral column .

Question 23

Neonatal congenital syphillis

Answer 23

has one characteristic feature involving osteomyelitis of the nose and shins. Causes a saddle nose that is characteristic of congenital syphillis.

Question 24

SCC and Osteomyelitis

Answer 24

YES> Squamous cell carcinoma can develop in the bone or sinus tract of ong standing osteomyelitis

Question 25

Involucrum

Answer 25

sub periosteal shell of viable new bone surrounding the osteomyelitis. Forms outside of the destroyed bone…KNOW

Question 26

Sequestrum

Answer 26

remaining fragment of necrotic cortical bone

Question 27

Involucrum is commonly a cfeature of

Answer 27

osteomyelitis

Question 28

Treponema Pallidum

Answer 28

Syphillis….a spirochete

Question 29

Tertiary syphillis is characterized by the formation of what>

Answer 29

Gumma: soft, tumor-like granulomas. They are chronic and represent an inability of the immune system to clear the organism. Gummas produce a chronic inflammatory state and have mass-effects on the local anatomy.

Question 30

Besides the gumma, what are other characteristics of unreated tertiary syphillis?

Answer 30

neuropathic joint disease, a degeneration of joint surfaces resulting from loss of sensation

Question 31

Saber shin is a feature of

Answer 31

Congenital syphillis

Question 32

What is saber shin

Answer 32

an anterior deformity of the tibia due to periostis and an inflammatory reaction at the outside of the bony cortex