Bone Pathology

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Author:
mrsexybrownman
ID:
110480
Filename:
Bone Pathology
Updated:
2011-10-20 01:01:12
Tags:
bone pathology joints disease osteo bones
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Description:
Bone and Joint Diseases
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  1. Achondroplasia
    • defect in cartilage growth
    • FGFR3 point mutation (Chr. 4)
    • autosomal dominant
    • usually spontaneous mutation
  2. Osteogenesis imperfecta
    • impaired collagen type I synthesis
    • osteoblast defect
    • type II disease fatal early in life
  3. Mucopolysaccharidosis
    • lysosomal storage disorder
    • buildup of SO32- in various cell types (GAG's)
    • cause hepatosplenomegaly and skeletal deformities
    • Type I = Hurler's (gargoylism) = a-L-iduronidase deficiency
    • Type II = Hunter's = iduronate-2-sulfatase deficiency
  4. Osteoporosis
    • loss of bone mass
    • difficulty bearing weight => fractures
    • vertebral compression fractures => kyphosis
    • 1o - age and menopause related
    • 2o - hypercorticism, hyperparathyroidism, malnutrition
    • estrogen and exercise important
  5. Osteopetrosis (Albers-Schonberg)
    • increased bone density
    • osteoclast defect
    • bone fractures easily despite increased density
    • impaired hematopoeisis due to reduced marrow space => anemia
    • cranial nerve compression from narrowed foramina
    • AR = fatal
    • AD = less severe
  6. Paget's Disease (osteitis deformans)
    • abnormal bone remodeling
    • 3 stages: osteolytic, mixed, late phases
    • (resorption, resorption + deposition => mosaic, deposition)
    • possibly caused by paramyxovirus
    • 85% polyostotic
    • high blood alkaline phosphatase and urine hydroxyproline
  7. Osteomalacia/Rickets
    • soft bones due to poor matrix calcification
    • Vit D deficiency
    • adults = osteomalacia
    • children = rickets
  8. Rickets deformities
    • pigeon chest
    • late fontanelle closure
    • rachitic rosary (string-of-beads appearance of ribs)
    • Harrison groove - depression along diaphragm
    • craniotabes - thin and soft parietal + occipital bones
  9. Osteitis fibrosa cystica (von Recklinghausen)
    • widespread osteolytic lesions
    • giant cell granulomas (brown tumors) - multinucleated osteoclasts
    • caused by hyperparathyroidism
    • high alkaline phosphatase
  10. Renal osteodystrophy
    • osteomalacia secondary to renal disease
    • renal failure => phosphate retention => hypocalcemia => increased PTH (2o hyperparathyroidism) => increased osteoclast activity
    • renal failure => low vitamin D => low Ca2+ absorption => see above
    • metabolic acidosis, Fe + Al deposits in bone
  11. Serum analysis results:
    normal Ca2+
    normal PO33-
    normal/low alkaline phosphatase

    Which metabolic bone disease is most likely?
    osteoporosis
  12. Serum analysis results:
    increased Ca2+
    decreased PO33-
    increased alkaline phosphatase

    Which metabolic bone disease is most likely?
    osteitis fibrosa cystica (von Recklingheusen)
  13. Serum analysis results:
    normal/low Ca2+
    variable PO33-
    normal/high alkaline phosphatase

    Which metabolic bone disease is most likely?
    osteomalacia/rickets
  14. Serum analysis results:
    normal Ca2+
    normal PO33-
    very high alkaline phosphatase

    Which metabolic bone disease is most likely?
    Paget disease (osteitis deformans)
  15. Tuberculous osteomyelitis
    • secondary to Tb infection located elsewhere
    • vertebral bodies (usually T and L) = Pott's disease
  16. Pyogenic osteomyelitis
    • S. aureus most common
    • can result in bone necrosis
    • involucrum (bone sleeve) can form around necrotic area
    • Brodie abscess = wall of granulation tissue formed
    • group B Strep and E. coli in newborns
    • Salmonella in sickle-cell patients
    • Pseudomonas in IV drug users

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