Regional Osteoperosis Flashcards
What are the 3 reasons regional osteoperosis can occur
- Disuse/immobilization osteoperosis
- CRPS
- Transient regional osteoperosis
Characteristics/age/timeline of transient osteoperosis of the hip
- sudden, reversible, idiopathic (may be associated w pregnancy in females)
- 20-40 yoa, M>F
- self limiting 3-12 months
Transient osteoporosis of the hip: symptoms and management
Symptoms: pain, antalgic limp, risk of fx
Management: no force in region, reduce weight bearing, self limiting 3-12m
CRPS age
> 50 yoa
CRPS mc sites
Distal to site of injury
-hand/shoulder
CRPS etiology and clinical pres
Follows minor trauma/ immobilization (3-6m post)
-believed to be due to over activity of sympathetic n system resulting in trophic changes to bone/soft tis
–acute onset of painful regional osteoperosis
Non specific clinical findings of CRPS
- hyperalgesia
- vasomotor abnormalities
- variable skin changes
- edema often present
CRPS imaging findings (3)
- patchy osteopenia (peri articular)
- soft tissue swelling
- sub periosteal bone resorption
Stage 1 of CRPS- timeline, symptoms
0-3 m
- radiographs usually normal*, may be positive bone scan
- puffy swelling, redness, warmth, decreased ROM
- -Aggressive tx best here!
Stage 2 of CRPS- timeline, symptoms
3-6m
- osteopenia on radiographs*
- worse pain, edema hardens, cyanosis, dry skin
Stage 3 of CRPS- timeline, symptoms
> 6-12m
- Severe osteopenia*
- skin pale, cool, pain dimish
management of CRPS
meds: corticosteroids, bisphosonates
physical/occupational therapy
CRPS prognosis
- if not caught early can spread to entire limb, bone, muscle
- muscle atrophy/functional impairment can be severe
Early tx essential (remission possible)
