Systemic Bone Disease Flashcards
<p>What are the three catagorys of systemic bone disease?</p>
<p>Metabolic, Nutritional, Endocrine</p>
<p>What does CATBITES stand for?</p>
<p>Congenital ARthritis Trauma Blood Infection Tumor Endocrine Soft Tissue</p>
<p>What Homrones and nutrients stimulate bone production?</p>
<p>Growth Hormone Thyroid hormone (T3, T4) Calcitonin Vit. D Vit. C</p>
<p>What hormones inhibit bone production?</p>
<p>Parathyroid hormone
| Cortisol</p>
<p>What is the termfor an all encompassing definition for increased radiolucency of bone?</p>
<p>Osteopenia</p>
<p>What is the most common etiology of osteopenia?</p>
<p>osteoporosis</p>
<p>What are some other etiologies that can cause osteopenia?</p>
<p>osteomalacia hyperparathyroidism Rickets Scurvy Neoplasm</p>
<p>T/F the finding of radiolucent on a bone on an x-ray is an automatic diagnosis of osteoporisis?</p>
<p>False</p>
<p>When bone resorption exceeds bone formation it is known as what? </p>
<p>osteopenia</p>
<p>What is done once osteopenia is discovered?</p>
<p> a search is done for more specific abnormalities </p>
<p>osteomalacia reveals linear radiolucenies called?</p>
<p>Looser's lines</p>
<p>HPT can produce subperiosteal and subchondral resorption and is normally found by what health care professional?</p>
<p>Dentsits</p>
<p>neoplasms such as plasma cell myeloma produce \_\_\_\_\_\_\_\_\_</p>
<p>focal lesions</p>
<p>If there are reasons for decreased bone density other than osteoporosis then we use the term \_\_\_\_\_\_\_\_\_\_\_\_\_</p>
<p>osteopenia</p>
<p>plain film is \_\_\_\_\_\_\_\_\_\_\_\_ to changes in bone mineral?</p>
<p>insensitive</p>
<p>What percentage of bone mass loss is needed before osteopenia can be diagnosed on a plain film?</p>
<p>30-50%</p>
<p>T/F Radiographic technique can widely alter the perception of whether or not osteopenia is present</p>
<p>True</p>
<p>In osteoporosis, bone is qualitatively \_\_\_\_\_\_\_\_,nad quantitatively \_\_\_\_\_\_\_\_\_ bone
a. normal; deficient
b. deficient; normal</p>
<p>a. </p>
<p>diagnosis of osteoporosis is made by the radiographic find of \_\_\_\_\_\_\_\_\_\_ </p>
<p>osteopenia</p>
<p>At what age does bone mass begin to decrease?</p>
<p>35</p>
<p>bone mass decreases due to reduced \_\_\_\_\_\_\_\_\_\_\_ differentiation, activity and life span</p>
<p>osteoblastic </p>
<p>What is more active in osteoporosis?
a. osteoblasts
b. osteoclast</p>
<p>b</p>
<p>What are the two reasons that women get osteoporosis faster than men?</p>
<p>hormonal deprivation
| increased osteoclast activity</p>
<p>what is the most common type of bone fracture in osteoporosis?</p>
<p>compression bone fractures in the vertebrea </p>
<p>Chance of hip fracture for women increase at what rate?</p>
<p>double every five year after 60</p>
<p>What are the two classification systems of osteoporosis?</p>
<p>primary and secondary</p>
<p>What are the example of primary osteoporosis?</p>
<p>Senile osteoporosis
Postemenopausal osteoporosis
transient or regional osteoporosis</p>
<p>What are some examples of secondary osteoporosis?</p>
<p>Corticosteroids Malignancy Infection Arthritides Disuse RSD</p>
<p>Cushing's disease is an example of \_\_\_\_\_\_\_\_\_ osteopenia</p>
<p>Endocrine</p>
<p>What percentage of the population will have osteoporosis after the age of 50?</p>
<p>55%</p>
<p>What is the mortality rate per year of osteoporosis?</p>
<p>10-20%</p>
<p>what percentage of patients will require long term nursing home care after a hip fracture?</p>
<p>25%</p>
<p>What is the best the way to diagnose for osteoporosis?</p>
<p>prior films of the patients </p>
<p>What color should the vertebrae be on a T1 MRI?
| If the patient has dark vertebrae?</p>
<p>White
it will be dark and an indicator of marrow replacement or possibly a tumor</p>
<p>the gradual loss of skeletal mass</p>
<p>Senile Osteoporosis</p>
<p>the increased bone loss seen in women following menopause </p>
<p>postmenopausal osteoporsis</p>
<p>the gradual loss of skeletal mass begins in women in the \_\_\_\_\_\_\_ decade</p>
<p>fourth</p>
<p>the gradual loss of skeletal mass begins in men in the \_\_\_\_\_\_\_\_\_\_\_decade</p>
<p>fifth or sixth</p>
<p>What three things occur with senile/postmenopausal osteoporosis?</p>
<p>pain (due to microfractures)
loss of height/compression fracture
accentuated kyphosis (thoracics). </p>
<p>what are some risk factors for osteoporosis?
| </p>
<p>Female >70 years Caucasian or Asian Early onset of menopause longer menopausal interval Inactivity, lack of weight bearing activities</p>
<p>cortical thinning "pencil thin" is an indicator of what condition?</p>
<p>osteoporosis</p>
<p>resorption of nonstress bearing trabeculae is a sign of what condition?</p>
<p>osteoporosis</p>
<p>vertical lines an x ray is an indicator of what condition?</p>
<p>osteoporosis</p>
a codfist deformity might be seen in a patient with _________
osteoporosis
prominent trabeculation and thin cortex
are signs of what condition?
osteoporosis
What are some spine findings of osteoporosis?
changes in vertebral contour uniform decrease in radiodensity is noted Endplate fractures/infarctions Compression fractures Pathologic fractures
What is the order of pathology in vertebrae shape?
step defect -> wedge deformity -> Biconcave vertebra -> pancake vertebra
if the compression exceeds 30% of the original body height or retropulsion is present or if neurologically compromised in the veretbra what is the suggested action?
take a CT scan
What are some reasons for doing a CT/MRI scan?
canal and neuroforaminbone marrow for differentiation between osteoporosis and pathologyal effacement
bone marrow for differentiation between osteoporosis and pathology
A loss of whiteness on an x ray is an indicator of what condition?
osteopenia
What are some radiographic manifestations of osteoporosis?
radiolucency altered trabecular pattern cortical thinning Wedge shaped vertebrae fish vertebrae, codfish deformity Schmorl's nodes End plate infractions
What are some reasons for a pathological compression fracture?
Osteoporosis
Lytic metastasis
Multiple myeloma
What makes a pathological compression fracture (why is it pathologic?)
decrease in height of the entire body
A pathological compression fracture can be attributed to what reason in a child?
Eosinophilic granuloma
What is the three column method criteria for mechanical stability of the vertebra?
Fracture of column A or C is stable.
Column B is unstable.
What are some features of osteoporosis in an extremity?
thinned cortices (pencil thin)
endosteal scalloping
loss of the secondary trabeculae
risks of fractures
What makes up Ward’s triangle?
primary compressive band (1)
secondary compressive band (2)
primary tensile band (3)
an accentuated wieght bearing trabeculation is also known as what?
pseudo hemangioma
Radiolucency of Ward’s trangle is more prominent in what condition?
osteoporosis
What is the last compressive component to be involved in osteoporosis?
advanced osteoporosis
In what direction does tensile group regress from?
medial to lateral this opens Ward’s trangle laterally
What is a possible outcome of adjusting someone with with a thoracic adjustment who has osteoporosis?
rib fractures
What are some reasons for pathological generalized osteoporosis/osteopenia?
plasma cell (multiple) myeloma metastasis anemia nutritional deficiencies diabetes mellitus immunodeficiency states chronic liver disease.
What test is performed to evaluate for osteoporosis?
DEXA scan
What does a DEXA scan measure for?
calcium content in the bones, this measure the bone mineral density
What is the term for the number of standard deviation from a young adult normals?
T-score
What does a T score predict?
predicts fracture risk
for every 1 standard deviation of a T score what is the increase in the chances of a fracture?
the risk doubles
What are some recommendations for the prevention of osteoporosis?
Stay active and get plenty of exercise supplement calcium protein and Vat C Don't smoke Don't drink excessively estrogen supplementation following menopause
What are some causes regional osteoporosis?
Immobilization and disuse
Reflex sympathetic dystrophy syndrome
Transient regional osteoporosis
Disuse osteoporosis inhibits _________ activity
a. osteoclast
b. osteoblast
b
What are some causes for disuse osteoporosis?
immobilized, paralysis, inflammatory joint ds
extremity injury
What is seen throughout the disused body part in a disuse osteoporotic patient?
diffuse osteopenia
What will be seen on an x-ray of a patient that suffered an extremity injury due to disuse osteoporosis?
- diffuse osteopenia seen throughout the disused body part
- lucent bands of osteopenia may be seen just proximal to the physeal line
- subchondral lucency
- uniform or spotty demineralization
What condition has clinical features of intense, burning pain, tactile stimulaion is painful, swelling, vasomotor disturbances, trophic skin changes including skin strophy and pigmentation abnormalities?
Reflex sympathetic dystrophy syndrome
What condition is characterized by acute pain, regional osteoporosis following trivial trauma?
Reflex sympathetic dystrophy syndrome
where does Reflex sympathetic dystrophy syndrome normally occur?
Hand
RSD has reflex hyperactivity of the _______
SNS
T/F imaging for reflex sympathetic dystrophy syndrome is specific enough to diagnose for it?
False, need clinical information
What is the age group for those with TOH?
middle aged adults 20-40