Clin Med: Musculoskelatal disorders

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  1. Osteogenesis imperfecta
    • Congential hereditary disorders
    • Problem in synthesis of Type 1 collagen
    • Leads to defects in bone, ears, joints, teeth
    • Severe form --> May have fractures at birth
    • Less severe --> fracture early in childhood
    • My develop hearing loss --> fracture of middle ear
  2. Osteoporosis
    • Decrease in bone mass
    • Can't maintain sufficient mechanical support
    • Malnutritin (calcium) and endocrine disturbances (estrogen decline) may have an impact
  3. Osteomalasia/Rickets
    • Vitamin D deficiency
    • Inadequate mineralization of bone matrix
    • Decrease in bone density
    • Osteomalasia- adult form; weight bearing bone deformities
    • Rickets- child form; "pigeon breast", lumbar lordosis, bowed legs
  4. Osteitis Fibrosa Cystica
    • Associated w/ advanced primary hyperparathyroidism
    • 1) early stage
    • 2) osteitis fibrosa
    • 3) osteitis fibrosa cystica
    • Lesion: osteoclastic resporption of bone w/ fibrous replacement
    • Formation of cysts
    • Mandible & maxilla initially affected
  5. Osteitis Deformans (Paget's disease)
    • Disordered bone remodeling --> mosaic pattern in bone
    • Mono or poly-ostotic
    • Unexplained pain & bone fractures & bone lysis
  6. Osteomyelitis
    • inflammation of bone from infection
    • Staphylococcus aureus
    • Suppurative inflammation, edema & bone necrosis
    • Either by:
    • Hematogenous route: in children, bacteriemia in long bones
    • Direct bone penetration: wounds, fractures, surgery
  7. Assymetric cartilage growth
    • Part of epiphyseal plate grows faster than the other
    • Usually hereditary
    • Can also be due to trauma/forces near epiphyseal plate
  8. Scoliosis: List
    • lateral tilt of the spine from the T1 level
    • May result from herniated disk or painful spasm of muscles along spine
  9. Scoliosis: Gibbus
    • Angular deformity noted w/ a collapsed vertebra
    • Causes: metestatic malignancy of the spine, tuberculosis
  10. Scoliosis: Flattening of the lumbar curve
    Suggest a herniated lumbar disk or ankylosing spondylitis
  11. Scoliosis: Kyphosis
    • may be 1st indication of osteoporosis in elderly
    • accompanied by pain in vertebral area & radiologic signs of osteoporosis
  12. Transverse Fracture
    Force perpendicular to long axis of the bone
  13. Compression fracture
    Force along the axis
  14. Spiral Fracture
    Torsional force
  15. 3 phases of fracture healing
    • Inflammatory: formation of granulation tissue; callus @ periphery of post-fracture; hemorrage clot
    • Reparative Phase: Pluripotent cells into fibroplasts & osteoblasts
    • Remodelling Phase: Reorganization & restoration; osteoblasts replaced w/ osteoclasts
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Clin Med: Musculoskelatal disorders
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