Di Exam 3 pt 5 ( regional osteoporosis)

• Disuse osteoporosis

• Complex Regional Pain Syndrome (CRPS)

• Transient Osteoporosis of the Hip

What are the regional osteoporosis conditions?

Disuse osteoporosis

What regional MSK movement stimulates osteoblastic activity

And Immobilization (injury, paralysis, joint diseases)

Extremity findings of disuse osteoporosis

o Diffuse osteopenia of that region

o Lucent bands of osteopenia proximal to the physeal line

o Subchondral lucency

o Uniform or spotty demineralization

Are all common findings of what?

Spotty carpal demineralization (disuse osteoporosis)

What does this show?

Complex regional pain syndrome (CRPS)

What does CRPS osteoporosis stand for?

CRPS osteoporosis

What is a neuropathic pain disorder defined by the presence

of distinct clinical features, including allodynia, hyperalgesia, sudomotor and vasomotor abnormalities, and trophic changes?

T

T/f: The pain experienced is disproportionate to the degree of

tissue injury and persists beyond the normal expected time for tissue healing when talking about CRPS.

Type 1

Type 2

What are the two subtypes of CRPS osteoporosis?

2

causalgia is what type of subtype of CRPS?

Type 1

reflex sympathetic dystrophy described what type of CRPS?

Type 1

Type 2

What subtype of CRPS osteoporosis occurs in the absence of nerve trauma ?

What type occurs in the setting of known nerve trauma?

CRPS osteoporosis

• Soft tissue swelling

• Regional osteoporosis

• Rapid, early mottled/patchy appearance, later generalized, could

become bilateral

• Aggressive and severe destruction of bone

• Significant juxta-articular osteoporosis

•Could involve the entireextremity

• Radionuclide imaging (bone scan)

Are all common finding in what condition?

CRPS osteoporosis:

Soft tissue swelling

Bilateral

Patchy appearance

What does this image show?

Transient osteoporosis of the hip (TOH)

What regional osteoporosis is More common in young adults (20-40) and has a higher association with pregnancy?

Men

Men

TOH is more common in what gender?

What gender is more commonly effected bilaterally?

Left

What hip more commonly affected in women with TOH?

T

T/f: The osteopenia is real; risk of fracture is higher than those without

TOH

Hot spots

Bone scan will demonstrate increased uptake of the radiotracer in TOH are called what?

Technitium pools in bladder

What cause the bladder to glow in a Bone scan?

Bone scan and MRI (T2, edema)

What are good imaging for TOH?

TOH

What cause a radiolucent femur head/hip region on the left?

MRI type 2

TOH

What is this imaging?

What condition?