Metabolic Bone Diseases Flashcards
Hyperparathyroidism:
Clinical findings?
Xray findings?
Kidney stones, hyperreflexia
Osteopenia, osteitis fibrosa cystica
Familial syndromes:
Clinical findings?
Xray findings?
Endocrine and renal abnormalities
Osteopenia
Hypoparathyroidism:
Clinical findings?
Xray findings?
Neuromuscular irritability, cataracts
Calcified basal ganglia
PHP/Albright’s syndrome:
Clinical findings?
Xray findings?
Short MC/MT, obesity
Brachydactyly, exostosis
Osteodystrophy:
Clinical findings?
Xray findings?
Renal abnormalities
“Rugger jersey” spine
Vit D deficiency rickets:
Clinical findings?
Xray findings?
Bone deformities, hypotonia, pathologic fractures (Looser’s zones: pseudofracture on compression side of bone), Milkman’s fracture
“Rachitic rosary”, wide growth plates, fractures, “codfish” vertebrae, coxa vara, retarded bone growth (defect in hypertrophic zone, widened osteoid seams)
Vitamin D-dependent (types I and II) rickets:
Clinical findings?
Xray findings?
Total baldness
Poor mineralization
Vitamin D-resistant (hypophosphatemic) rickets:
Clinical findings?
Xray findings?
(Most common form of rickets)
Bone deformities, hypotonia
Poor mineralization
Hypophosphatasia:
Clinical findings?
Xray findings?
Bone deformities, hypotonia
Poor mineralization
Osteoporosis:
Clinical findings?
Xray findings?
Kyphosis, fractures
Compression vertebral fractures, hip fractures
Scruvy:
Clinical findings?
Xray findings?
Fatigue, bleeding, effusions
Thin cortices, corner sign
Paget’s:
Clinical findings?
Xray findings?
Deformities, pain, CHF, fractures
Coarse trabeculae, “picture frame” vertebrae
Osteopetrosis:
Clinical findings?
Xray findings?
HSM, anemia
Bone within bone
WHO definition of osteoporosis?
Lumbar (L2-4) density is 2.5 or more SDs less than mean peak bone mass of a healthy 25 year old
WHO definition of osteopenia?
Bone density is 1.0 to 2.5 SDs less than the mean peak bone mass of a healthy 25 year old
Osteoporosis stats:
1) After initial vertebral fx, risk for a 2nd is?
2) Lifetime risk of fx in white women after 50 years?
3) Risk for hip fracture?
1) 20%
2) 75%
3) 15-20%
Types of osteoporosis?
Type I: postmenopausal = affects trabecular bone, vertebral and distal radius fxs common
Type II: age related = affects trabecular AND cortical bone, hip and pelvic fxs common, more related to poor Ca absorption
Tx of osteoporosis?
1) Exercise
2) Ca supplements = 1000-1500mg/day (more effective in type II)
3) Vit D supplements = 400-800IU/day
4) Fluoride
5) Bisphosphonates
What can you see in 3rd trimester of pregnancy?
Idiopathic transient osteoporosis of hip
What’s required for dx of osteomalacia?
Biopsy (transiliac)
Histologic finding of scurvy?
Widening of the zone of provisional calcification in the physis
