From Textbook (Disease Vocabulary) - Unit 4: The Skeletal System

avascular necrosis

Death of cells in the epiphysis of a long bone, often the femur. This is caused by an injury, fracture, or dislocation that damages nearby blood vessels or by a blood clot that interrupts the blood supply to the bone.

Treatment: Surgery to remove the dead bone, then a bone graft. For large areas of avascular necrosis, joint replacement surgery is done.

bone tumor

Osteoma is a benign tumor of the bone. Osteosarcoma is a cancerous bone tumor in which osteoblasts, the cells that form new bone, multiply uncontrollably. It also known as osteogenic sarcoma. Ewing's sarcoma is a cancerous bone tumor that occurs mainly in young men.

Treatment: Surgical removal of a benign tumor. Amputation of the limb followed by radiation therapy or chemotherapy drugs for a cancerous tumor.

chondroma

Benign tumor of the cartilage.

Treatment: Surgical removal, if large.

chondromalacia patellae

Abnormal softening of the patella because of thinning and uneven wear. The thigh muscle pulls the patella in a crooked path that wears away the underside of the bone.

Treatment: Strengthening of the thigh muscle to correct the direction of its contraction.

fracture

Broken bone due to an accident, injury, or disease process. Fractures are categorized according to how the bone breaks. A fracture caused by force or torsion during an accident or sports activity is a stress fracture. A fracture caused by a disease process such as osteoporosis, bone cancer, or metastases to the bone is a pathologic fracture. Fractures that are allowed to heal without treatment often show malunion or malalignment of the fracture fragments.

Treatment: Closed reduction and manipulation to align the fracture pieces, application of a cast. Surgery: Open reduction and internal fixation using wires, pins, screws, or plates.

closed fracture

Broken bone does not break through the overlying skin

open fracture

Broken bone breaks through the overlying skin. It is also known as a compound fracture.

nondisplaced fracture

Broken bone remains in its normal anatomical alignment

displaced fracture

Broken bone is pulled out of its normal anatomical alignment

Colles' fracture

Distal radius is broken by falling onto an outstretched hand

comminuted fracture

Bone is crushed into several small pieces

compression fracture

Vertebrae are compressed together when a person falls onto the buttocks or when a vertebra collapses in on itself because of disease

depressed fracture

Cranium is fractured inward toward the brain

greenstick fracture

Bone is broken on only one side. This occurs in children because part of the bone is still flexible cartilage.

hairline fracture

Very thin fracture line with the bone pieces still together. It is difficult to detect except on an x-ray.

oblique fracture

Bone is broken on an oblique angle (see Figure 8-18)

spiral fracture

Bone is broken in a spiral because of a twisting force

transverse fracture

Bone is broken in a transverse plane perpendicular to its long axis

osteomalacia

Abnormal softening of the bones due to a deficiency of vitamin D in the diet or inadequate exposure to the sun whose rays make vitamin D in the skin. In children, this causes rickets with bone pain and fractures.

Treatment: Vitamin D supplement, sun exposure.

osteomyelitis

Infection in the bone and the bone marrow. Bacteria enter the bone following an open fracture, crush injury, or surgical procedure.

Treatment: Antibiotic drug.

osteoporosis

Abnormal thinning of the bone structure. When bone breakdown exceeds new bone formation, calcium and phosphorus are lost, and the bone becomes osteoporotic (porous) with many small areas of demineralization. This can cause a compression fracture as a vertebra collapses in on itself. The vertebral column decreases in height, the patient becomes shorter, and there is an abnormal curvature of the upper back and shoulders (dowager's hump). Osteoporosis can also cause a spontaneous fracture (pathologic fracture) of the hip or femur. Sometimes it is unclear whether an older patient fell and fractured the bone or whether the osteoporotic bone itself spontaneously fractured and caused the patient to fall. Osteoporosis occurs in postmenopausal women and older men. Estradiol in women stimulates bone formation, and loss of estradiol at menopause leads to osteoporosis. A lack of dietary calcium and a lack of exercise contribute to the process.

Treatment: Bone density test for diagnosis; drug to decrease the rate of bone resorption or drug to activate estradiol receptors, and calcium supplement.

ankylosing spondylitis

Chronic inflammation of the vertebrae that leads to fibrosis, fusion, and restriction of movement of the spine.

Treatment: Nonsteroidal anti-inflammatory drug.

kyphosis

Abnormal, excessive, posterior curvature of the thoracic spine. It is also known as humpback or hunchback. The back is said to have a kyphotic curvature. Kyphoscoliosis is a complex curvature with components of both kyphosis and scoliosis.

Treatment: Back brace or surgery to fuse and straighten a severely curved spine.

lordosis

Abnormal, excessive, anterior curvature of the lumbar spine. It is also known as swayback. The back is said to have a lordotic curvature.

Treatment: Back brace or surgery to fuse and straighten a severely curved spine.

scoliosis

Abnormal, excessive, C-shaped or S-shaped lateral curvature of the spine. The back is said to have a scoliotic curvature. A dextroscoliosis curves to the patient's right, while a levoscoliosis curves to the patient's left. Scoliosis can be congenital but most often the cause is unknown. It develops during childhood and may continue to progress during adolescence. It impairs movement, posture, and breathing. An x-ray shows the degree of curvature.

Treatment: Back brace or surgery to fuse and straighten a severely curved spine.

spondylolisthesis

Degenerative condition of the spine in which one vertebra moves anteriorly and slips out of proper alignment due to degeneration of the intervertebral disk. It can also occur because of a sports injury or a compression fracture of the vertebra from osteoporosis. Treatment: Back brace or surgery to relieve a pinched spinal nerve. Analgesic drug, nonsteroidal anti-inflammatory drug. Intra-articular injection of a corticosteroid drug.

arthralgia

Pain in the joint from injury, inflammation, or infection from various causes.

Treatment: Correct the underlying cause.

arthropathy

Disease of a joint from any cause.

Treatment: Correct the underlying cause.

dislocation

Displacement of the end of a bone from its normal position within a joint. This is usually caused by injury or trauma. Congenital dislocation of the hip (CDH) is present at birth because the acetabulum is poorly formed or the ligaments are loose.

Treatment: Manipulate and return the bone to its normal position. Congenital dislocation of the hip is treated with a splint or with surgery to correct the shape of the acetabulum or looseness of the ligaments.

gout

Metabolic disorder that occurs most often in men. There is a high level of uric acid in the blood. An acute attack causes sudden, severe pain after uric acid moves from the blood into the soft tissues and forms crystals known as tophi. Historically, patients with gout have been pictured with throbbing big toes, although tophi can form in any joint in the feet or hands. Tophi in the joints causes gouty arthritis.

Treatment: Avoid foods that increase the uric acid level. Drug to decrease the uric acid level.

hemarthrosis

Blood in the joint cavity from blunt trauma or a penetrating wound. It also occurs spontaneously in hemophilic patients.

Treatment: Temporary immobilization of the joint, aspiration of blood from the joint cavity, corticosteroid drug. Surgery: Arthroscopy.

Lyme disease

Arthritis caused by a bacterium in the bite of an infected deer tick. There is an erythematous rash that expands outward from the bite for several weeks (bull's-eye rash) but is not itchy; there is joint pain, fever, chills, and fatigue. If untreated, Lyme disease can cause severe fatigue and affect the nervous system (numbness, severe headache) and the heart.

Treatment: Antibiotic drug.

osteoarthritis

Chronic inflammatory disease of the joints, particularly the large weight-bearing joints (knees, hips) and joints that move repeatedly (shoulders, neck, hands). Osteoarthritis (OA) usually begins in middle age, but can develop sooner in a joint that has been overused or injured. There is joint pain and stiffness. There is inflammation from constant wear and tear, and this is worsened if the patient is overweight. The normally smooth cartilage becomes roughened and then wears away in spots. The bone ends rub against each other, causing additional inflammation and crepitus, a grinding sound. New bone sometimes forms abnormally as an osteophyte, a sharp bone spur that causes pain. Osteoarthritis is also known as degenerative joint disease (DJD).

Treatment: Analgesic drug, nonsteroidal anti-inflammatory drug. Intra-articular injection of a corticosteroid drug. Surgery for a joint replacement.

rheumatoid arthritis

Acute and chronic inflammatory disease of connective tissue, particularly of the joints. RA is an autoimmune disorder in which the patient's own antibodies attack cartilage and connective tissue. Patients are usually young to middle-aged females. There is redness and swelling of the joints, most often of the hands and feet. The joint cartilage is slowly destroyed by inflammation. The symptoms flare and subside over time, and there is progressive deformity of the joints.

Treatment: Corticosteroid drug. Surgery: Joint replacement surgery.

sprain

Overstretching or tearing of a ligament around a joint.

Treatment: Rest or surgery to repair the ligament.

torn meniscus

Tear of the cartilage pad of the knee because of an injury.

Treatment: Arthroscopy and repair.

pectus excavatum

Congenital deformity of the bony thorax in which the sternum, particularly the xiphoid process, is bent inward, creating a hollow depression in the anterior chest.

Treatment: Surgical correction, if severe.genu valgum