Skeletal System Pathology 2

Question 1

Metabolic bone disease consist of

Answer 1

Osteoporosis

Osteomalacia

Rickets

Gout

Paget’s Disease

Caused by abnormalities of the bones caused by disorders of minerals

Question 2

Osteoporosis

Answer 2

Generalized or localized deficiency of bone matrix in which the mass of bone per unit volume is decreased in amount but normal in composition

Causes include aging and postmenopausal hormonal changes

A decrease in kVp is required to obtain a quality image

Question 3

Osteoporosis appearance

Answer 3

DEXA imaging, QCT imaging are used to diagnose

Cortical thinning, most evident in the spine/pelvis

Question 4

Osteomalacia

Answer 4

Insufficient mineralization of the adult skeleton

May be caused by inadequate intake or absorption of calcium, phosphorus, or vitamin D.

Question 5

Osteomalacia appearance

Answer 5

Loss of bone density

Cortical boarders become thin and appear indistinct

Question 6

Rickets

Answer 6

The systemic disease of infancy and childhood

Calcification of the growing skeletal elements because of lack of vitamin D or sunshine.

Question 7

Rickets Appearance

Answer 7

Overgrowth of non-calcified osteoid tissue

Metaphyseal ends become cupped and frayed

Bowing of weight-bearing bones

Osteoid tissue in the sternal ends of the ribs produce a beading appearance

Question 8

Gout

Answer 8

Disorder in the metabolism of purine

An increase in uric acid in the blood, which leads to the deposition of uric acid crystals in the joints.

Manifests as very arthritis that initially attacks a single joint, primarily the first toe

Question 9

Gout Appearance

Answer 9

First appears like arthritis

Early signs=joint effusions/periarticular swelling

Clumps of urate crystals

Question 10

Paget’s Disease

Answer 10

Also known as osteitis deformans

One of the most common chronic metabolic diseases of the skeleton

Associated increased risk of osteosarcoma later in life

No known cure

In men more than women

Question 11

Paget’s Disease appearance

Answer 11

Skull-sharply demarcated radiolucencies.
Skull-irregular islands of sclerosis and cortical thinking

Bone scans show cold spots during the destructive phase, hot spots during the reparative phase

Enlargement of vertebral bodies in the spine

The pelvis is the most common initial site

Question 12

Lead poisoning

Answer 12

Ingestion of lead-containing materials.

Environmental exposure occurs when drinking water or eating food stored in lead containers

Lead is the number one major environmental pollutant

May cause mental retardation, seizures, behavioral disorders, or delayed development.

Children are most susceptible to lower doses.

Question 13

Lead poisoning Appearance

Answer 13

Lead lines with dense transverse bands

Lead collects in most rapidly growing areas

Mottled opacities on abnormal x-rays

Question 14

Fibrous Dysplasia

Answer 14

The proliferation of fibrous tissue within the medullary cavity

Causes loss of trabecular markings and widening of the bone.

Occurs in women more, and happens in long bones

Question 15

Fibrous Dysplasia Appearance

Answer 15

Radiolucent area

Expanded bone

Bowing/Deformity

Question 16

Ischemic Necrosis of Bone

Answer 16

Occurs due to lack of blood supply, circulation

Question 17

Ischemic Necrosis of Bone appearance

Answer 17

Radiolucent subcortical bands

A patter of lytic and sclerotic areas

Nuc med bone scans: cold spots-lytic phase; increased activity-reparative phase

Question 18

Benign bone tumors (Benign Neoplasms)

Answer 18

Osteochondroma
Enchondroma
Osteoclastoma
Osteoma
Osteoid Osteoma
Simple bone cyst
Bone Island

Question 19

Osteochondroma

Answer 19

Also known as exostosis

Benign projection of bone with a cartilaginous cap that arises in childhood of the teen years

Long axis of tumor runs parallel to the bone shaft

Points away from the nearest joint

Question 20

Enchondroma

Answer 20

Slow growing benign cartilaginous tumors arising in the medullary canal

Primarily in the small bones of hands and feet

Often found when a fracture occurs with minimal force

Question 21

Osteoclastoma or Giant cell tumor

Answer 21

Typically arises at the end of the distal femur or proximal tibia of a young adult after epiphyseal closure

Does not affect the joint

Question 22

Osteomas

Answer 22

Most often arise in the outer table of the skull, the paranasal sinuses, and mandible

They cause pain

2 cm diameter

Question 23

Osteoid Osteoma

Answer 23

Imaged as small, round or oval, lucent center, less than 1 cm in diameter, that is surrounded by a large, dense sclerotic zone of cortical thickening

Most common in teenagers or young adults

Symptoms are local pain

Question 24

Simple bone cyst

Answer 24

Unicameral-one chamber

true fluid-filled cyst with a wall of fibrous tissue. Most often occurs in the proximal humerus or femur

Asymptomatic

Often discovered either incidentally or after fracture

Question 25

Aneurysmal bone cysts

Answer 25

Not a true cyst or neoplasm

Consist of numerous blood-filled, arteriovenous communications though to be caused by trauma

Question 26

Bone Island

Answer 26

Solitary, sharply demarcated areas of dense compact bone that occur most commonly in the pelvis and upper femur

They appear in every bone except the skull

Question 27

Malignant bone tumors/neoplasms

Answer 27

Osteogenic Sarcoma
Chondrosarcoma
Ewing's Sarcoma
Multiple Myeloma
Bone Mesastisis

Question 28

Osteogenic sarcoma

Answer 28

Occurs at the end of the long bone in the metaphysics especially in the knee

Malignant tumor of osteoblast, which produces osteoid and spicules of calcified bone

most common in persons between 10 and 25 years

Question 29

Chondrosarcoma

Answer 29

Malignant tumor of cartilaginous orgin that may originate anew or within a preexisting cartilaginous lesion.

Commonly occurs in long bones, but often originates in a rib, scapula, or vertebra

Is about half as common as osteogenic sarcoma

usually develops at a later age like 35-60, and grows more slowly

Question 30

Ewing’s Sarcoma

Answer 30

A primary malignant tumor arising in the bone marrow of the long bones

It occurs in children and young adults.

Rare over 30 yrs old

Question 31

Multiple Myeloma

Answer 31

A widespread malignancy of plasma cells

Associated with bone destruction, bone marrow failure, hypercalcemia, renal failure, and recurrent infections

The disease affects primarily persons between 40-70 years of age

Question 32

Bone Metastasis

Answer 32

The most common malignant bone tumor

spread by the bloodstream and lymphatic vessels or by direct extension

The most primary tumors are carcinomas of the breast, lung, prostate, kidney, and thyroid

Favorite sites of the spread are bones containing red marrow, such as the spine, pelvis, ribs, skull, and the upper ends of the humerus and femur