Path 11 Bone Pathology Flashcards
Osteoid main component
Type 1 collagen
Osteocalcin
Vit K dependent
-Binds to hydroxyapatite -> mineralization
Osteonectin
Calcium binding protein
Hydroxyapatite crystals
CaPO4 packed around collagen
Achondroplasia
FGF-R3 gene mutation (chondrocyte proliferation)
-Sporadic or autosomal dominant
Osteogenesis Imperfecta
Improper Type 1 collage synthesis
- Autosomal dominant
- Recurrent fractures
- Blue sclera
- Hearing/Dental abnormalities
Osteopetrosis
Carbonic anhydrase II mutation (Howship lacunae)
- No remodelling, bones fill up
- Recessive/Malignant, Dominant/Benign
Osteopetrosis clinical
Extramedullary hematopoiesis (Hepatosplenomegaly)
- Erlenmeyer flask deformities
- Neural foramina compression
- Renal tubular acidosis (CA II mutation -> decreased HCO3 resorption)
Rickets
Childhood Vit D deficiency
-Pigeon chest, bowing long bones, frontal bossing, rachitic rosary (rib cartilage)
Osteomalacia
Adult vit D deficiency
- Weak bones
- Increased osteoid on histo
- Down Ca, PO4
- Up Alk Phosph, PTH
Osteoporosis
Reduced bone mass, degenerating matrix
- Vertebral and Hip fractures
- Avoid glucocorticoids
Osteoporosis Dx
DEXA scan
-labs are normal
Paget disease
Osteoclast dysfunction in elderly
- Osteoclasts hyperresponsive to RANK
- Paramyxovirus etiology
Paget disease phases
1- Osteolytic phase (osteoclasts)
2- Mixed phase (osteoblast overdrive)
3- Osteosclerotic phase (both stop)
Paget disease histo
Mosaic pattern of lamellar and woven bone
Paget disease clinical
Hat gets tighter
Lion facies
Hearing loss
Bone deformity/fracture
Avascular osteonecrosis
Children and adolescents
- Carpal bones and head of femur
- Osteoarthritis if subchondral bone involved
Osteomyelitis causes (1)
- Most common
- Sexually active
- Diabetics
- Staph Aureus
- Gonorrhea
- Pseudomonas
Osteomyelitis causes (2)
- Children
- Sickle cell
- Dog bites
- Direct spread
- H. influenzae
- Salmonella
- Pasteurella
- Mixed bacterial
Sequestrum
- Acute
- Bone necrosis due to suppurative/ischemic injury
Involucrum
- Chronic
- Reactive bone deposition around infected bone