Joint/Bone

Question 1

Osteoarthritis

Answer 1

• Unbalanced articular cartilage degradation and replacement
• Degenerative joint disease
• Aging wear and tear or secondary to trauma
• Articular cartilage fibrillation and cracking
• Eburnation (ivory bone)
• Subchondral cysts
• Osteophytes (bony outgrowths)

Question 2

Answer 2

Cartilage fibrillation and cracking

Question 3

Rheumatoid Arthritis

Answer 3

Immunologically mediated
-T cells/MACs = cytokines/TNF
-Proliferation of synovium and fibroblasts
-B cells make RF

Question 4

Answer 4

Rheumatoid Arthritis with ulnar deviations

Question 5

Gout

Answer 5

-Hyperuricemia, then monosodium urate crystals deposited in joints
-Neuts and Macs
-Gouty tophi form, granuloma crystals

Question 6

Answer 6

Gout

Question 7

Answer 7

Gouty tophus, granuloma-like

Question 8

Osteoporosis

Answer 8

• Reduced bone mass, decrease
  -0.7% per year after 30
• Senile and post-menopausal forms
• Diminished osteoblastic gusto
• Thinner and fewer trabeculae in cancellous bone
  – Especially vertebral bodies and femeral neck
  – Resulting compression and hip fractures

Question 9

Answer 9

Osteoporosis

Question 10

Answer 10

Normal vs. Osteoporosis

Question 11

Hyperparathyroidism

Answer 11

-Primary: adenoma or hyperplasia
-Secondary: renal failure
-Increased PTH = unabated osteoclast activity
-Brown tumor of bone/osteitis

Question 12

Answer 12

Hyperparathyroidism with multiple osteoclasts dissolving bone to release calcium

Question 13

Answer 13

Hyperparathyroidism with multiple osteoclasts dissolving bone to release calcium

Question 14

Answer 14

Osteosarcoma

Question 15

Answer 15

Osteosarcoma

Question 16

Answer 16

Osteosarcoma

Question 17

Chondrosarcoma

Answer 17

• 1/2 as frequent as osteosarcoma
• 40-60 year old pts
• Pelvis shoulders, ribs
• Grade matters
  *low 85% survival rate
  *high 43% survival rate

Question 18

Answer 18

Chondrosarcoma

Question 19

Answer 19

Chondrosarcoma, low grade on left, high grade on right

Question 20

Multiple Myeloma

Answer 20

• Cancer in the bone, but not of the bone
• 15% of deaths from tumors of WBCs
• Clonal proliferation of post-follicular center B cells, i.e. plasma cells

Question 21

Answer 21

Multiple Myeloma with lytic lesions in skull

Question 22

Answer 22

Multiple Myeloma with malignant proliferation of plasma cells