MSK and bones

Question 1

Chalk-stick fractures

Answer 1

Chalk-stick fractures are the classic x-ray findings or Paget’s disease of the bone.

Paget’s disease of the bone (osteitis deformans) is commonly asymptomatic or a mild disease that manifests in adults. It will present with an enlarged head and impingement on cranial nerves is common.

Defective remodeling involeves an increase in both osteoblastic and osteoclastic activity and causes lytic and sclerotic lesions.

Serum calcium, phosphorus, and PTH is normal but ALP is elevated

Question 2

Decreased osteoclast activity is characteristic of what disease?

Answer 2

Osteopetrosis

Osteopetrosis is characterized by thickened, dense bones that are prone to fracture.

additional findings include pancytopenia and extramedullary hematopoiesis

x-rays show diffuse symmetrical skeletal sclerosis (bone-in-bone) or “stone bone)

bone marrow transplant is potentially curative

Question 3

Primary bone tumor with lytic lesions

Answer 3

Multiple myeloma

CRAB

hyperCalcemia, renal failure, anemia, back pain

Question 4

trendelenburg gait

Answer 4

Weakness in abductor muscles

gluteus medius, gludeus minimus, tensor fascia late

injury to the superior gluteal n

can be caused during an IM injection to the upper medial gluteal region