MSK path V Flashcards
osteopenia
decreased bone mass
osteoporosis
osteopenia that is severe and increase risk of fracture
type of neuropathy assoc with osteoporosis
radiculopathies from collapsing vertebrae
iatrogenic osteopenia
over Tx hyperthyroid
primary causes osteopenia
idiopathic
postmenopausal
senile
what contributes to senile and postmenopausal types of osteopenia
age related changes, reduced physcial activity, genetic factors, Ca nutritional state, hormonal influences
what increases in menopause
IL1 IL6 TNF
RANK and RANKL
osteoclast activity
what happens to bone mass from aging
decreased replication
decrease synthetic activity of osteoblasts
decreased activity of GF
reduced physical activity
why are the vertebral bodies susceptible in osteoporosis postmenopausal
have greatest SA
trabecular plates lose connections
explain bone changes in senile osteoporosis
Cx is thinned by subperiosteal and endosteal resorption
Haversian systems widened
can mimic cancellous bone
complications in fractures of long or big bones in osteoprosis can lead to what
PE and pneumonia
what is osteitis deformans
paget disease
icnreased disordered
phases of pagets
osteolytic
mixed
osteosclerotic
moasic pattern of lamellar bone
jigsaw puzzle like appearance from prominent cement lines
pagets
the mosaic pattern in pagets means what
in sclerotic phase
clinical sign pagets
usually asymptomatic
probably fracture
majority pagets is monostotic or poly
poly
what bones are most involved inpagets
axial skeleton and proximal femur
leontiasis ossea
enalrgement craniofacial skeleton from remodeling in pagets
what benign lesions develop in pagets
giant cell tumor, giant cell reparative granuloma, extra osseous masses of hematopoietic tissue
malignant development of pagets
sarcoma
lab finding in pagets
increased alkaline phosphatase
normal Ca and phosphorus
what will you feel over painful lesion if pagets
increased temperature because increase in blood flow to that area
bowing
thickeing of cortical and cancellous bone is called what and seen when
saber bone
seen in pagets
rickets and osteomalacia
Vit D deficiency in children and adults
what happens in Vit D deficiency
under-mineralization of bone
what is rachitic rosary baby
abrnomal mineral homeostasis
from rickets
“string of beads”
post common cause hyperPTH
PTH adenoma
what happens to bone in hyperPTH
increase osteoclast activation increase bone resoprtion and Ca mobilization
PTH mediates effect because increases RANKL expression
mineral effects of hyper PTH
increased resorption of Ca by renal tubules
increased urinary excretion of phosphates
increased synthesis of active Vit D 1,25 OH by kidneys
increased active vit D will do what
increase Ca absorption in gut and mobilize bone Ca buy inducing RANKL
what will occur in hyperPTH if ostoclasts proliferate
dissecting osteitis, looks like train tracks
what is a brown tumor
benign
from a fracture( can be caused by dissecting osteitis)
blood turns into hemosiderin which gives brown appearance
renal osteodystrophy
skeletal changes that occur in chronic renal disease(assoc with dialysis)
metabolic acidosis will cause bones to soften
osteopenia, osteomalacia, hyper PTH and growth retardation
hyperPTH can lead to
osteoprosis, brown tumors osteitis fibrosa cystica
simple fracture
overlying skin intact
compound fracture
bone communicates with skin surface
comminuted fracture
bone is fragmented
displaced fracture
ends of bone at fractures site are not aligned
stress fracture
slowly developing fracture that follows a period of increased physical acitivity in which bone is subjected to repetitive loads
green stick fracture
extending only partially through bone, seen in infants because bone is still soft
pathologic fracture
involving bone weakened by underlying disease process, such as tumor
conditions assoc with osteonecrosis
alcohol bisphosphonate use corticosteroid administration CT disorders gaucher disease infection pregnancy radiation therapy sickle cell crisis trauma tumors
what artery gets compromised in avascular necrosis of femoral head
branch of obturator that supplies superior part of femoral head
what bone is not affected by medullary infarcts
cortex because collateral flow
subchondral infarct morphology
wedge shaped segment of tissue undergoes necrosis
overlying cartilage remains viable because nutrients from synovial fluid
what occurs in necrotic area of bone
saponification
osteomyeltisis
inflammation of bone and marrow
almost always secondary to infection
