Pathologic Findings in MSK disease Flashcards
more reactive metabolically, classification of bone
cancellous bone
provides structural stability
cortical
lengths of long bones are formed by?
endochondral ossification
metabolic products of type 1 collagen
pyrodoniline,deoxy-
non-collagen protein that prevents mineralization and promotes bone resorption
osteocalcin
derived from osteoprogenitor cells
osteoblasts
bone not laid out along stress lines,easily broken
woven bone
collagen type of basal lamina,liber,bv
4
ellis-van creveld syndrome oyher name,
chondrodectodermal dysplasia - autosomal dominant,
jeune’s syndrome?
severe narrowing if the chest cage
marble bone disease
osteopetrosis
forms of osteopetrosis that is seen in parental consanguinity? give characteristic
malignant ar.
- splenomegaly, hepatomegaly
2’ extramedullary hematopoiesis
3 leukopenia
caused by error in the gene that causes acidifiction which is necessary for bone resorption
osteopetrosis
aka as camurati-engelmnn disease
progressive diaphyseal disease
_____ is a disorder involving syn of of ____. there is abundance of _____ bone
1 osteogenesis imperfecta
2 type 1 collagen
3 woven
extra feats: blue sclerae, dentonogenesis imperfecta
causes of overproduction of pth
pth adenoma (80%) pth hyperplasia 20%
deugs that decrease Ca absorption
dilantin,phenobarbital
occurs in esrd
pathogenesis
appear histologically as
- renal osteodystrophy
- reduced gfr of phosphorous leads to hyperphos. High Phosphate in blood = lower Calclium levels. Decreased Calcium leads to secondary hyperparathyroidism
- high and low turnover disease, mixed type
- appears as osteitis fibrosa (histologically)
most common cause and other causes of low turnover osteodystrophy
Al toxicity ( Al has higher affinity to hydroxyapatite than calcium) vitamins D steroids and Calcium ( when icreased supresses pth)
stain used to detect calclium
von kossa stain
principally attacks synovial joints, usu. peripheral joints in s systenic distribution.
RA
RA turns the synovium to ____ tissue
lymphoid like
“Triad” of raynaud’s disease
- Endothelial activity
- CT tissue design
- TH17 involvement
signs of Dermatomyositis
- HEliotrope sign
- Gottron’s papules
- ERytematous rash
ankylosing spondylitis mainly affects what joints?
Spine and sacroiliac joints
Two varietes of Primary Osteoporosis
Senile
Post menopausal
causes of secondary osteoporosis
Diabetes , corticosteroid therapy, drcondary amenorrhea
Steps in fracture healing
1 ACtual Break 2. Inflammation 3 Granulation Tissue 4 Soft Callus 5 Bony Callus 6 Bone remodelling
STrong constant movement along a healing callus in cyst formation produces a
Pseudoarthrosis
Causes of OSteonecrosis
1 Fracture 2 Croticosteroids 3 Thrmobosis and embolism 4 VAscular injury caused by radiation 5 increased interoosseous pressure 6 Venous HPN
Subchondral infracts vs Medullary infracts
Subchondral infarcts: chronic pain, progressive (usually needs replacement)
MEdullary: Silent, exccept when extensive
Osteonecrosis XR will appear
Increased radiopacity
Histology of Osteonecrosis
trabecular bone with empty lacunae, fibrosis and ruptured fat cells
Inflammation of the bone and marrow spaces
OSteomyelitis
CAuses of pyogrnic osteomyelitis
1 hematogenous spread (
2 /direct spread (ask for tooth extractions, abscess in tibia)
3 direct implantation (stab wound)
XR in osteomyelitis
Foci of sclerosis (involucrum)
Lytic changes
Etiologic agent in Brodie’s Abcess
Staphylococcus
Sclerosis that has increased production of osteoid
Usu. in jaw
Chronic Sclerosing Osteomyelitis of Garre
kyphoscoliosis and granuoma in the vertebra is caused by
Tuberculous OSteomyelitis (Pott’s disease)
biphasic peak of Osteosarcoma
1st peak at less than 20 with second peak in the 5th to 6th decade
XR findings in osteosarcoma
Codmans Triangle, Sunburst Appearance
In osteosarcoma, this is lifted from the periosteum and will act as scaffolding where tumor ells will atach
Sharpey’s fibers
/chondrosarcoma usually involves what bones
Pelvis and scapulae
CArtillage forming tumor arise from the monocyte phagocytic lineage neoplastic components are the monunuclear stromal cells
GCT
In RA, Specific sets of HLA alleles have been identified which share an epitope in the HLA-DR gene. Which rheumatoid factor have arginine found in the epitope? Which has worse prognosis?
Seronegative = Arginine in the epitope Seropositive = Lysine, worse prognosis
hyperplastic synovium inflitrated by inflammatory cells that become adherent to the underlying cartillage in RA
Pannus
Histology of RA
Allison Ghormly bodies, Thick synovial tissue
May involve organs resulting to Uveitis, carditis, aortitis
Spondyloarthropathy
primary gout is due to what enzyme defect
HGRPT
Secondary gout due to
Inc. nucleic acid turnover, renal disease, inborn error metabolism
Normal serum range of URic acid
0.21 - 0.43 mmol/L
FOUR distinct morphological changes in Gout
1 acute arthritis- neutrophilic infiltration in synovial tissue
2 chronic tophaceous arthritis
3 Tophi - urate crystals surrounded by macrophages,forming a granuloma
4 Gouty nephropathy - urate crystals in the renal medullary interstitium
soft tissue tumor prognostication
1 Histological classification
2 grade
3 stage
4 location
4 variants of liposarcoma, what has best prognosis?
Well-differentiated (best prognosis)
myxoid, round, pleomorphic (worse prog)
Most common soft tissue tumor in children and adolescents
Rhabdomyosarcoma
Most common translocation in Rhabdomyosarcoma
t(2;13), (35;14)
3 histological Subtypes of rhabdomyosarcoma
/embryonal, alveolar, pleiomorphic
Grape like clusters if rhabdomyosarcoma aooeared in preformed cavities (bladder, vagina, nasal cavity)
Sarcoma Botryoides
Histo of Rhabdomyosarcoma, where do you find tadpole shaped cells
spindle cells with very eosinophilic cytoplasm
High-grade pleiomorphic - Tadpole shaped cells since they copy formation of skeletal muslces
chronic systemic inflammation that mainly involved diarthroidal joints
RA
OA causes muscle spasms, muscle atrophy , radicular pain, and neurologic deficits thru what pathophysiology
Progressive Destruction of the joint causes production of osteophytes at the periphery, Osteophyte at the vertebral foramina may impinge on nerves resulting in the symptoms above
