Metabolic Bone Disease Flashcards
Define Paget’s disease of the bone
Localized disorder of bone turnover, increased bone reabsorption which is followed by increased bone formation.
What is the bone like in Paget’s disease
Bigger
Less compact
More vascular
More susceptible to deformity and fracture
What are some of the symptoms of Paget’s disease?
> 40 y/o Bone pain Bone deformity Excessive heat over the bone Neurological complication i.e. nerve deafness
What are some of the clinical signs of Paget’s disease?
Isolated elevation of serum alkaline phosphate.
Rare development of osteosarcoma in affected bone.
How to treat symptomatic Paget’s disease
IV Bisphosphate therapy or one-off dose of IV Zoledronic Acid.
What are the 2 diseases caused by severe nutritional vitamin D and Ca deficiency, which causes insufficient mineralisation?
Rickets-Children
Osteomalacia - Adults
How does Vitamin D affect bone and muscles?
Vitamin D stimulates the absorption of Ca and Phosphate from the gut making it available for bone mineralisation, muscle function is also impaired in a low Vitamin D state.
What is Osteogenesis Imperfecta?
A genetic disorder of connective tissue which is characterized by fragile bones from mild trauma and even acts of daily life.
What are the 4 most common types of Osteogenesis Imperfecta?
Type I: Mild form (when a child starts to walk)
Type II: Lethal by age 1
Type III: Progressive deforming with severe bone dysplasia and poor growth.
Type IV: Similar to type I but more severe
Signs and symptoms of Osteogenesis Imperfecta
Growth deficiency Defective tooth formation Hearing loss Blue sclera Scoliosis Barrel Chest Easy bruising
What is the suggested medical and surgical management of Osteogenesis?
Surgical: Treat fractures
Medical: Prevent fractures and IV Bisphosphates
What is Osteoporosis?
A metabolic bone disease which is characterized by low bone mass and micro architectural deterioration of the bone tissue.
What are the main investigations for osteoporosis?
Prodigy scanner
DXA scan of spine and hips
What are some of the endocrine causes for Osteoporosis?
Thyrotoxicosis Hyper and Hypothyroidism Cushings Hyperprolactinaemia Hypopituitarism Early menopause
What are the rheumatoid causes of osteoporosis ?
Rheumatoid arthritis
Ankylosing spondylitis
Polymyalgia rheumatica
