Locomotor: Aging Bones Flashcards
Second most common metabolic bone disease?
Paget’s disease of the bone
What is Paget’s disease of the bone and what are the 3 phases?
It is an unusual remodelling of the bone
The phases are:
1. Osteolytic phase, predominantly resorption by osteoclasts
2. Mixed phase, resorption with compensatory formation
3. Osteosclerotic phase, predominantly formatoin by osteoblasts
Paget’s disease of the bone clinical symptoms
- Enlarged skull
- Bowing of long bones
- Large joint OA
- Fractures
- Nerve compression leading to deafness
What is the bad prognosis in 1% of Paget’s disease patients
Paget’s sarcoma
Paget’s disease of the bone investigations and treatments
Insetigations:
- Imaging
- Lab results elevated ALP
Treatments:
- Osteoclast inhibition
- Arthroplastly
What is hyperparathyroidism
Increasing level of PTH as a results of excessive production from one or more parathyroid glands
Main effects of PTH
- Incourages OBs to release mroe RANKL
- Increases renal uptake of vit d which also increases RANKL
Hyperparathyroidism symptoms and signs
Bones, stones, abdominal groans, thrones, psychic moans
Primary hyperparathyroidism
This is due to an abnormality in the parathyroid glands
This is treated with a parathyroidectomy (removal)
Secondary hyperparathyroidism
This where the PT is simply releasing too much PTH and is usually a result of vit d deficiency
This is treated by treating vit d deficiency
What is rickets?
Insufficient calcium or phosphate prior to physeal closure
What is congenital rickets?
Inherited inability of kidneys ot absord phosphate
What is acquired rickets?
Rickets due to vitamin d deficiency
Rickets presentation
- Bowing of long bones
- Brittle bones
- Flattening of skull
- Kyphosis
Rickets treatment
- Aquired: Vit d and calcium
- Congenital: Calcitriol
Can perform surgery to correct deformaties
What is osteomalacia
Rickets but after physeal closure
Osteomalacia presentation
- Atypical fractures
- Loose areas of bone
- Femoral/ femoral neck fractures
- Hip arthritis with protrusio (femoral head goes too far into acetabulum)
Osteomalacia treatment
Phatty amounts of vit d
Why are post menopausal women more prone to osteoporosis?
Without estrogen osteoblast release more RANK-L
What are compression wedge fractures and what are the knock-on effects
These are acumalated stress or low energy trauma fractures which usually only happen with weakened bone from osteoporosis
Results in:
- Height loss
- Reduced pulmonary volume
- Protruding abdomen
- Constipation
- Early satiety
The two classifications of wrist fracturs
- Smith’s - volar
- Colles’ - dorsal
Treatment of an intracapsular hip fracture
Screw or Arthroplasty depending on blood supply to femoral head
“pin it or bin it”
What is arthroplasty
Replacement of a joint
Treatment of an extracapsular hip fracture
Pin it
If intertrochanteric sliding hip screw
If subtrochanteric intramedullary nail
