Musculoskeletal Disorders Part 2 Flashcards
What are the three phases of Paget’s Disease?
Osteolytic phase, mixed osteolytic and osteoblastic phase, osteosclerotic phase
What is the older term for Paget’s Disease?
Osteitis Deformans
What occurs in Paget’s Disease?
Massively enlarged, disorganized, and irregular bone that is prone to fractures
The appearance of Paget’s Disease of the pelvis on X-ray is what?
Fuzzy/shaggy looking
What is the name of the perpendicular fractures seen on X-ray with Paget’s Disease?
Chalk stick fracture
What is the appearance of the bone cells with Paget’s Disease?
Mosaic, jigsaw puzzle appearance
Most cases of Paget’s Disease are asymptomatic: true or false?
True (up to 90%)
What are the general symptoms of Paget’s Disease when they’re present?
Bone pain, multiple fractures, nerve compression
What is found in the diagnosis of Paget’s Disease?
Increased levels of serum alkaline phosphatase
What is a positive note on the current findings of Paget’s Disease diagnoses?
It is becoming less common and less severe
What population is more like to develop Paget’s Disease?
Caucasians
Why are there increased levels of serum alkaline phosphatase in those with Paget’s Disease?
It is a byproduct of osteoblast activity
When ivory vertebra sign is present, what are likely causes?
Paget’s Disease, metastatic cancer (usually from prostate cancer), lymphoma
What is ivory vertebra sign?
Increased density of one specific vertebral level
If a patient comes in saying they’ve noticed their hats don’t quite fit anymore, it could be indicative of what condition?
Paget’s Disease
What named conditions result from vitamin D deficiency?
Rickets (in children) or osteomalacia (in adults)
What is the average age of diagnosis of Paget’s Disease?
70 years (older individuals)
What gender is at a greater risk for Paget’s Disease?
Males (2X)
What is the treatment for Paget’s Disease?
Bisphosphonates
What is the intention with treating Paget’s Disease with bisphosphonates?
Slowing of the osteolytic (first) phase
Vitamin D deficiency has what effect on bone?
Decreased bone mineralization (less calcium)
What are ways vitamin D deficiency can occur?
Malnutrition, deficient UV Rays, abnormal metabolism
Femoral and tibial bowing is a sign of what condition?
Vitamin D deficiency
Which is more severe: rickets or osteomalacia?
Rickets
Osteomalacia is associated with what issue?
Hyperparathyroidism
Osteomalacia is similar to what condition?
Osteoporosis
What is secreted from the parathyroid glands?
Parathyroid hormone (PTH)
What is the main function of the parathyroid glands?
Maintains serum calcium (in blood)
What type of hyperparathyroidism involves autonomous PTH production?
Primary
What is the most common cause of excessive PTH?
From an adenoma (80%)
Excessive PTH has what kind of effect on bone cells?
Increased osteoclast activity
What is absorbed more heavily from renal tubules in a state of excessive amounts of PTH?
Vitamin D and calcium
What can result from secondary hyperparathyroidism?
Mild renal failure
How is hyperparathyroidism diagnosed?
Hypercalcemia, parathyroid immunoassay
What is the most common nonmalignant cause of hypercalcemia?
Hyperparathyroidism
In which group is hyperparathyroidism most common?
Post menopausal women
In what percentage of cases is hyperparathyroidism asymptomatic?
> 50%
Hyperparathyroidism results in resorption of what type of bone?
BOTH cortical and trabecular bone
When cortical and trabecular bone are resorbed in hyperparathyroidism, what replaces that bone?
Loose connective tissue
In what condition can a “brown tumor” result?
Hyperparathyroidism
What is a “brown tumor”?
Collection of loose connective tissue filling a space, giving off a bloody appearance (not actually a tumor but a lesion)
Renal stones, peptic ulcers, bowing of long bones, and pathological fractures are present with what condition?
Hyperparathyroidism
The salt & pepper skull is indicative of what condition?
Hyperparathyroidism
What is a condition that produces holes in the skull that can appear similar to the salt and pepper skull seen on X-rays of those with hyperparathyroidism?
Multiple myeloma
Rugger-jersey spine is seen on X-rays of those with what condition?
Hyperparathyroidism
Bone pain, fractures, deformation, kidney stones, nausea, anorexia, fatigue, and decreased cognition are features of what condition?
Hyperparathyroidism
What are possible treatments for hyperparathyroidism?
Drinking water and physical activity, avoidance of diuretics (water pills)
Is hyperparathyroidism possibly reversible?
Yes, with normalization of PTH levels
Subperiosteal resorption of the radial side of the middle phalanges is unique to what condition?
Hyperparathyroidism
What issues in muscle can be seen with hyperparathyroidism?
Weakness, aches, and fasciculations
