Musculoskeletal Pathology - Bikman Flashcards
Describe the differences between osteoblasts, osteoclasts, osteocytes
Osteoblasts- creates bone matrix and signals osteoclasts
Osteoclasts- degrades bone
Osteocytes- embedded osteoblasts
What is the ligand that activates osteoclasts?
RANK
What regulates RANK?
Osteoprotegerin (OPG)
Osteogenesis Imperfecta
Congenital Disease Many types based on collagen Blue Sclera Dentinogenesis imperfecta Multiple fractures Hearing loss
Achondroplasia
Congenital Disease
Dwarfism
Affects the long bones
Autosomal dominant
Osteopetrosis
Congenital Disease "stone bone" Bone cannot be reabsorbed Dense, but brittle bones Autosomal recessive and dominant Delayed erruption of teeth
Fiberous Dysplasia
Congenital Disease
Replacing bone with soft tissue
Three types: monostotic, polystotic, McCune-Albright Syndrome
Osteoporosis
Acquired Disorder
Loss of bone, but same ratio of minerals
Primary- from age
Secondary- from everything else
Paget Disease
Acquired Disorder
Random excess bone formation
Can cause osteosarcoma, heart disease, deafness or blindness
Ricketts / Osteomalacia
Acquired Disorder Deficiency in Vitamin D Ricketts- young Osteomalacia- older Weak tooth enamel; higher risk for caries
Hyperparathyroidism
Acquired Disorder
Primary- excess secretion of PTH from one or more parathyroid glands
Secondary- increase of PTH from a chronic disease
Can get loss of lamina dura
Scurvy
Acquired Disorder
Too little vitamin C
Leads to impaired osteoid matrix formation
Manifestations include- osteoporosis, bleeding gums, subperiosteal hemmorraging (bleeding in bone)
Langerhans’ cell histiocytosis
Acquired Disorder
Birbeck granules
Cause bone lesions
Describe the repair process of a fracture
Blood vessel rupture
Platelet clotting
Bone progenitor cells cover fractured site
Osteonecrosis
From ischemia (lack of blood and oxygen) Not from infection
Bisphosphonate-associated necrosis (BON)
Comes from after a patient has taken Bisphosphonate for osteoporosis
Can interfere with formation of bone after surgery or injury
Can get phossy jaw
Osteomyelitis
2 Types: pyogenic and tuberculous
Pyogenic- caused by bacteria infections
Tuberculous- caused by tuberculosis and affects the long bones and vertebrae
What are the routes of spreading of osteomyelitis?
Hematogenous dissemination
Contiguous infection spread
Traumatic implantation
Osteoma
Benign Bone forming tumor
Affects the face
Older people
Normal bone
Osteoid Osteoma
Benign Bone forming tumor
Metaphysis of the femur and tibia
Woven bone
Younger people
Osteoblastoma
Benign Bone forming tumor
Like osteoid osteoma
Vertebrae
Younger people
Primary osteosarcoma
Malignant Bone forming tumor
Usually affects the femur
Younger people
“Sunburst pattern” on radiograph
Secondary osteosarcoma
Malignant Bone forming tumor
Femur, humerus, pelvis
Osteochondroma
Benign Cartilage forming tumor
10-30 years of age
Bone and cartilage as a cup
Enchondroma
Benign Cartilage forming tumor
30-50 years of age
Small bones of the hands and feet
Chondrosarcoma
Malignant Cartilage forming tumor
Older people
Affects pelvis, humerus, femur
Osteoarthritis
Degradation of the cartilage Most common joint disorder Affects older people Primary- age Secondary- younger people with no reason
Rheumatoid Arthritis
Destruction of articular cartilage and underlying bone
More common in women
Bilateral
Likely a combo of genetics and environment
Type 4 autoimmune disease
Seronegative Spondyloarthropathies
Inflammation of ligaments
HLA associated
Gout
From urate crystal formation because of supersaturated fluids
Primary- absence without any other disease
Secondary- occurs along with another disease
Suppurative Arthritis
Acquired from S. aureus in adults or haemaphilus influenza in kids
pyogenic fluid in joints
Lyme Arthritis
From Borrelia
Ganglion cysts
Fluid filled usually near the wrist
“Bible therapy”
Synovial cysts
Herniation of synovium though a joint capsule
Needs surgery
Lipoma
Benign Fat forming tumor
most common soft tissue tumor
Liposarcoma
Malignant fat forming tumor
Prognosis depends on differentiation
Affects older people
