chapter 38- degenerative disorders

Osteoporosis definition

Porous bone with low density and deterioration of bone matrix

Osteopenia definition

Early thinning of trabecular bone before osteoporosis

Osteoporosis pathophysiology

Osteoclast activity > osteoblast activity → bone loss.

Primary osteoporosis etiology

Negative Ca balance, poor nutrition, low weight-bearing activity, low estrogen/testosterone, low sunlight

Secondary osteoporosis etiology

Hyperparathyroidism, corticosteroids, celiac disease, IBD, malabsorption

Bones most effected by osteoporosis

Hips, vertebrae, wrists

Osteoporosis symptoms

Silent until fracture occurs; back pain, kyphosis

Osteoporosis risk factors

Age, post-menopause, low mobility, hormonal disorders, low Ca/Vit D, smoking, small frame

Osteoarthritis (OA) pathophysiology

Degeneration of cartilage → exposed bone → inflammation → osteophyte formation.

OA locations

Weight-bearing joints: knee, hip, spine; also hands

OA etiology

Wear and tear; obesity; previous injury

OA symptoms

Deep arching pain, worse with activity, relieved with rest; morning stiffness; crepitus

OA physical signs

Heberden nodes and Bouchard’s nodes (PIP); joint deformity; decreased ROM

Rheumatoid arthritis (RA) pathophysiology

Autoimmune attack on synovial tissue→ chronic inflammation → cartilage and bone destruction.

RA symptoms

Symmetric tender joints; fatigue; fever; morning stiffness

RA deformities

Swan neck; boutonniere

Rickets pathophysiology

Failure of osteoid calcification in children due to vitamin D deficiency

Rickets signs

Wide growth plates; bowing of femur; sternum protrusion; delayed fontanel closure

Osteomalacia cause

Vitamin D deficiency in adults

Osteomalacia symptoms

Lumbar pain; bone pain when tibia/sternum palpated; muscle weakness

Degenerative disc disease (DDD) pathophysiology

Disc degeneration→ disc collapse or herniation → nerve compression.

osteophytes may form as well

DDD symptoms

Back pain; weakness; numbness; radiculopathy

DDD risk factors

Heavy lifting, obesity, twisting trauma