Metabolic Bone Disease

Question 1

Rickets?

• what do you see on Xray in Rickets?

buzzwords for rickets?

Answer 1

not enough. Reduced density. Tibial bowing

X- Rays show widening and cupping of the epiphysis of the long bones, most readily apparent in the wrist.

The child is small for age and there is a history of failure to thrive.

Question 2

Reduced bone density

• osteoporosis
• osteopaenia
• which one is more severe?

osteogenesis imperfecta

• what type of collagen abnormality?
• clinical features?
• Tx?
• buzz words for osteogenesis imperfecta?

Answer 2

• osteoporosis is more severe than osteopenia

Osteogenesis Imperfecta

• type 1 collagen abnormality
• blue sclera
• lots of fractures
• Tx: phosphanase

multiple fractures, particularly of the long bones, wormian bones (irregular patches of ossification) and a trefoil pelvis

Question 3

Increased Density

• osteopetrosis?
• what do you see on Xray in osteopetrosis?
• osteopoikilosis?

Answer 3

• ‘marble bone disease’ - overly dense bones throughout the body

x-rays show brittle bones with no differentiation between the cortex and the medulla.

-very rare - aress of dense and normal bone - on XR - looks like patchy white and black bone

Question 4

Mixed Density

Paget’s disease?

Answer 4

• Paget’s Disease – usually affects only one bone, imbalance between bone being laid down and broken. Susceptible to fracture