SKELETAL SYSTEM PATHOLOGY

A CONGENITAL DEFECT THAT USUALLY HAS NO CLINICAL SIGNIFICANCE

BUTTERFLY VERTEBRA

THIS IS A SUPERNUMERARY OR EXTRA RIB THAT IS ATTACHED TO C7

CERVICAL RIB

IT IS A POORLY DEVELOPED OR RUDIMENTARY RIB THAT IS PRESENT IN APPROXIMATELY 0.05% OF THE POPULATION

CERVICAL RIB

• IT IS USUALLY UNILATERAL BUT IN SOME CASES, THEY CAN BE BILATERAL

CERVICAL RIB

THE CONCERN WITH A_ IS THAT IT MAY COMPRESS THE BRACHIAL NERVE PLEXUS OR THE SUBCLAVIAN ARTERY AND THUS REQUIRE SURGICAL REMOVAL

CERVICAL RIB

THIS DISEASE IS ONE OF THE MOST COMMON CAUSES OF KNEE PAIN IN YOUNG ATHLETES.

OSGOOD-SCHLATTER DISEASE

MAINLY AFFECTS BOY AGES 10-16

OSGOOD-SCHLATTER DISEASE

IT IS A CONDITION WHERE THE TIBIAL TUBEROSITY BECOMES INFLAMED FOLLOWING EXERCISE

OSGOOD-SCHLATTER DISEASE

OSGOOD-SCHLATTER DISEASE TREATMENT CONSISTA OF?

REST

THIS IS RELATIVELY RARE CONGENITAL BONE DISORDER THAT IS CHARACTERIZED BY BONES THAT EASILY BREAK

OSTEOGENESIS IMPERFECTA

THIS CONDITION IS SOMETIMES REFERRED TO AS "BRITTLE BONE DISEASE"

OSTEOGENESIS IMPERFECTA

PEOPLE WITH OI ARE BORN WITH INSUFFICIENT AMOUNTS OF A PROTEIN CALLED WHICH PLAYS IMPORTANT ROLE IN BONE FORMATION

TYPE 1 COLLAGEN

OSTEOGENESIS IMPERFECTA IS A COLLAGEN DEFICIENCY THAT WILL RESULT IN WHICH IS A DECREASE IN THE NUMBER OF OSTEOCYTES

OSTEOPENIA

• THE NET RESULT IS THE FORMATION OF FRAGILE OR SEVERELY DEFORMED BONES

OSTEOGENESIS IMPERFECTA

IN SEVERE CASES, MULTIPLE FRACTURES CAN FORM WHILE THE FETUS IS IN THE WOMB. AS A RESULT, MANY INFANTS ARE STILL BORN OR DIE SHORTLY AFTER BIRTH

OSTEOGENESIS IMPERFECTA

IN 2000, _ PLAYED A CHARACTER WITH OI CALLED MR. GLASS IN A MOVIE WITH BRUCE WILLIS, ENTITLED UNBREAKABLE

SAMUEL L. JACKSON

THE SEVERE BOWING THAT HAS OCCURRED IN THIS PATIENT'S HUMERUS AND FOREARM ARE AN INDICATION THAT THE PATIENT IS SUFFERING FROM A CONDITION KNOWN AS

OSTEOGENESIS IMPERFECTA

THIS DISORDER RESULTS FROM A DISORDER OF ENDOCHONDRAL OSSIFICATION AND IS THE OPPOSITE OF OSTEOPOROSIS

OSTEOPETROSIS

SOMETIMES REFERRED TO AS "MARBLE BONE"

OSTEOPETROSIS

DISEASEPATIENTS WITH THIS VERY RARE CONDITION POSSESS BONE THAT ARE VERY HARD AND DENSE ODDLY ENOUGH, THEIR BONES TEND TO BE MORE BRITTLE THAN NORMAL

OSTEOPETROSIS

OSTEOPETROSIS CAN BE AT BIRTH OR _ INTO ADULTHOOD

FATAL
ASYMPTOMATIC

DOES OSTEOPETROSIS HAVE DEFINITIVE TREATMENT?

NONE

CHILD OSTEOPETROSIS IS CALLED?

INFANTILE OSTEOPETROSIS

CHARACTERIZED BY A REDUCTION IN BONE MASS THAT MAKES PATIENTS WITH THIS CONDITION SUSCEPTIBLE TO FRACTURE FORMATION.

OSTEOPOROSIS

THE UNDERLYING MECHANISM IN ALL CASES IS AN IMBALANCE BETWEEN THE BODY'S NORMAL PROCESS OF BONE DESTRUCTION FOLLOWED BY BONE GROWTH

OSTEOPOROSIS

PRIMARY CAUSES OF OSTEOPOROSIS ARE

AGING AND POSTMENOPAUSAL HORMONE CHANGES

OTHER CAUSES OF OSTEOPOROSIS INCLUDE

STEROID USE, OSTEOGENESIS IMPERFECTA, MULTIPLE MYELOMA, AND INACTIVITY

PATIENTS WITH THIS CONDITION ARE PRONE TO HIP FRACTURES, COMPRESSION FRACTURES OF THE VERTEBRAL BODIES, AND COLLES' FRACTURES OF THE WRIST

OSTEOPOROSIS

A COMMON METHOD TO DIAGNOSE THIS CONDITION IS BY THE USE OFOSTEOPOROSIS

A DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA) SCAN.

PROVIDES A NON INVASIVE MEANS TO MEASURE BONE MINERAL DENSITY (BMD).

DEXA SCAN

DISEASE IS CHARACTERIZED BY A SOFTENING OF BONES THAT RESULTS FROM INSUFFICIENT MINERALIZATION.

OSTEOMALACIA

MAY CAUSE A "BOWING" OF BONES OR LEAD TO GREENSTICK FRACTURES.

OSTEOMALACIA

IT CAN BE CAUSED BY A DECREASE IN ABSORPTION OF EITHER VITAMIN D OR CALCIUM.

OSTEOMALACIA

IT CAN ALSO BE MANIFESTED IN CHILDREN WHO INGEST AN INSUFFICIENT AMOUNT OF VITAMIN D OR WHO ARE NOT EXPOSED TO ENOUGH SUNLIGHT

OSTEOMALACIA

THIS CONDITION IS THE RESULT OF A BACTERIAL BONE INFECTION THAT CAUSES BONE DESTRUCTION AND ABSCESS FORMATION

OSTEOMYELITIS

• ONE CHARACTERISTIC OF OSTEOMYELITIS IS

FORMATION OF A BRODIE'S ABSCESS.

IT IS TYPICALLY FOUND IN THE TIBIA AND IS AN INDICATION OF OSTEOMYELITIS

BRODIE'S ABSCESS

AN AVASCULAR "ISLAND" OF BONE THAT FORMS WITHIN AN ABSCESS. CHARACTERISTICT OF OSTEOMYELITIS

SEQUESTRUM FORMATION

IT IS COMMONLY REFERRED TO AS A BONE-IN-BONE FORMATION. CAN BE ACUTE OR CHRONIC.

OSTEOMYELITIS

IT IS USUALLY TREATED WITH PROLONGED ANTIBIOTIC THERAPY

OSTEOMYELITIS

THIS TYPE OF ARTHRITIS CAN INVOLVE JOINTS, MUSCLES, TENDONS, LIGAMENTS, AND BLOOD VESSELS

RHEUMATOID ARTHRITIS

IT BEGINS AS A CHRONIC INFLAMMATION OF SYNOVIAL MEMBRANES THAT LINE JOINTS.

RHEUMATOID ARTHRITIS

(RHEUMATOID ARTHRITIS) THICKENED TISSUE () FORMS AS A RESULT OF THE INFLAMMATION AND THIS CAUSES EROSION OF THE ARTICULAR CARTILAGE.

PANNUS

(RHEUMATOID ARTHRITIS) FIBROUS SCARING OCCURS FOLLOWED BY ANKYLOSIS OR "__"

FREEZING OF THE AFFECTED JOINT

THE NET RESULT IS A CRIPPLING DEFORMITY WHICH BEGINS IN THE EXTREMITIES AND PROGRESSES TOWARD THE TRUNK

RHEUMATOID ARTHRITIS

CAN RELAPSE BUT MAY STILL HAVE INTERMITTENT FLAIR UPS

RHEUMATOID ARTHRITIS

THIS DISEASE AFFECTS WOMEN THREE TIMES MORE OFTEN THAN MEN

RHEUMATOID ARTHRITIS

• SIGNS AND SYMPTOMS OF RA (RHEUMATOID ARTHRITIS

MORNING STIFFNESS, PAIN, AND ULNAR DEVIATION OF THE FINGERS.

TREATMENT FOR RHEUMATOID ARTHRITIS INCLUDES?

STEROIDS TO REDUCE THE INFLAMMATION AND ANALGESICS (ASPIRIN) FOR PAIN

THIS IS A CHRONIC, DEGENERATIVE ARTHRITIS THAT USUALLY BEGINS IN THE SACROILIAC (SI) JOINTS AND SPREADS TO THE SPINE.

ANKYLOSING SPONDYLITIS

IT IS CHARACTERIZED BY OSTEOPOROSIS AND FUSION OF THE SI JOINTS AND VERTEBRAL BODIES

ANKYLOSING SPONDYLITIS

.DUE TO ITS VERY DISTINCTIVE RADIOGRAPHIC APPEARANCE, IT IS COMMONLY REFERRED TO AS "BAMBOO SPINE" DISEASE.

ANKYLOSING SPONDYLITIS

TREATMENT FOR ANKYLOSING SPONDYLITIS INCLUDES

STEROIDS TO REDUCE THE INFLAMMATION AND ANALGESICS (ASPIRIN) FOR PAIN

BETWEEN THE YEARS AND _, APPROXIMATELY 10,000 MALE PATIENTS SUFFERING FROM ANKYLOSING SPONDYLITIS WERE TREATED WITH DOSES RANGING FROM 1 TO 40 GY IN GREAT BRITAIN.

1935 AND 1954

BACK IN THE EARLY 20TH CENTURY, X-RAYS WERE CONSIDERED A _ FOR MOST ANY ILLNESS INCLUDING ANKYLOSING SPONDYLITIS.

PANACEA

UNFORTUNATELY THE HIGH DOSES REQUIRED TO PROVIDE THIS RELIEF FOR ANKYLOSING SPONDYLITIS OFTEN LEAD TO____

LEUKEMIA FORMATION

OR METABOLIC ARTHRITIS, IS A DISORDER OF PURINE METABOLISM THAT RESULTS IN AN INCREASE IN URIC ACID PRODUCTION.

GOUT

GOUTR IS ALSO CALLED AS

METABOLIC ARTHRITIS

THE EXCESS URIC ACID IN GOUR IS DEPOSITED IN

BLOOD, KIDNEYS, AND JOINTS

(GOUT) J_ FORM AS CRYSTALS THAT CAUSE A VERY PAINFUL INFLAMMATORY REACTION

JOINT DEPOSITS

• GOUT IS PRIMARILY MANIFESTED IN

FEET (GREAT TOE) BUT IT CAN ALSO AFFECT OTHER AREAS SUCH AS THE HANDS AND KNEES

MOST COMMON DEGENERATIVE JOINT DISEASE. CHARACTERIZED BY A NATURAL LOSS OF JOINT CARTILAGE THAT IS RELATED TO BUT NOT CAUSED BY AGING.

OSTEOARTHRITIS

(OSTEOARTHIRITS) THE BODY REPLACES THIS LOSS OF CARTILAGE WITH THE FORMATION OF NEW BONE IN THE FORM OF ____. THESE __ CAUSE THE PAINFUL INFLAMMATION THAT IS ASSOCIATED WITH THIS CONDITION.

SPURS

CAN AFFECT MOST JOINTS IN THE BODY INCLUDING THE HANDS, WRISTS, HIPS, AND SPINE.

OSTEOARTHRITIS

SIGNS AND SYMPTOMS OF OSTEOARTHRITIS

JOINT STIFFNESS AND PAIN THAT INCREASES WITH ACTIVITY

IT IS ALSO AFFECTED BY THE WEATHER AND OBESITY

TREATMENT FOR OSTEOARTHRITIS

STEROIDS TO REDUCE THE INFLAMMATION, ANALGESICS (ASPIRIN) FOR PAIN, AND JOINT REPLACEMENT SURGERY (TOTAL HIP REPLACEMENTS)

PAGET'S DISEASE IS ALSO KNOWN AS

OSTEITIS DEFORMANS

CHARACTERIZED BY AN ABNORMAL CYCLE OR PROCESS OF BONE DESTRUCTION FOLLOWED BY EXCESSIVE BONE GROWTH AND THICKENING

PAGET'S DISEASE

COMMONLY SEEN IN THE PELVIS, LUMBAR SPINE, AND SKULL.

PAGET'S DISEASE

SIGNS AND SYMPTOMS OF PAGET'S DISEASE

BONE PAIN, DEFORMITY, ARTHRITIS, AND FRACTURES

THIS CONDITION IS CHARACTERIZED BY A CLEFT BETWEEN THE SUPERIOR AND INFERIOR ARTICULATING PROCESSES AT THE PARS INTERARTICULARIS

SPONDYLOLYSIS

• IT IS USUALLY BILATERAL AND THE NET RESULT IS A LOSS OF THE NEURAL ARCH CONTINUITY.

SPONDYLOLYSIS

• IT IS COMMONLY FOUND 90% OF THE TIME BETWEEN L5 AND S1

SPONDYLOLYSIS

GENERAL DEGENERATION OF THE SPINE

SPONDYLOSIS

IS CHARACTERIZED BY THE FORWARD MOVEMENT (SUBLUXATION) OF ONE VERTEBRAL BODY ON THE ONE BELOW IT.

SPONDYLOLISTHESIS

THIS CAUSES THE VERTEBRAL CANAL TO NARROW AND THUS IMPINGE ON THE NERVE ROOTS IT HAS FOUR GRADES (I, II, III, IV)

SPONDYLOLISTHESIS

TREATMENT FOR SPONDYLOLISTHESIS

BACK SUPPORT/BRACES AND SURGERY.

• INFLAMMATION THAT CAUSES ARTHRITIS

SPONDYLITIS

IS AN OSTEOSCLEROTIC BONE DYSPLASIA THAT IS LITERALLY TRANSLATED AS "SPOTTED BONES."

OSTEOPOIKILOSIS

• IT PRODUCES MANY SMALL RADIOPAQUE DENSITIES THAT ARE SOMETIMES REFERRED TO AS BONE ISLANDS. • IT HAS AN UNKNOWN ETIOLOGY AND IS USUALLY ASYMPTOMATIC

OSTEOPOIKILOSIS

ARE COMMON, BENIGN, EXPANSILE, RADIOLUCENT LESIONS THAT ARE FILLED WITH FLUID.

BONE CYSTS

THEY ARE MORE PREVALENT IN MALES THAN FEMALES AND HAVE AN UNKNOWN ETIOLOGY.

BONE CYSTS

DEPENDING ON BONE CYSTS'S _ , THEY MAY CAUSE PAIN OR EVEN A PATHOLOGIC FRACTURE. OTHERWISE, THEY HAVE NO SIGNIFICANCE.

LOCATION

GENERAL CATEGORIES OF BONE TUMORS

OSTEOLYTIC AND OSTEOBLASTIC

THEY RESULT IN A DECREASE IN BONE DENSITY AND HAVE A LUCENT RADIOGRAPHIC APPEARANCE.

OSTEOLYTIC

THEY RESULT IN AN INCREASE IN BONE DENSITY AND HAVE AN OPAQUE RADIOGRAPHIC APPEARANCE

OSTEOBLASTIC

THIS IS A CARTILAGINOUS, BENIGN BONE LESION THAT IS FOUND IN BONE MARROW. • IT IS MOST COMMONLY FOUND IN YOUNG ADULTS.

ENCHONDROMA

ENCHONDROMAS ARE MOST OFTEN LOCATED IN THE BONES OF

HANDS, FEET, AND RIBS.

THEY PRESENT WITH A RADIOLUCENT, "CYSTIC" APPEARANCE WITH CALCIUM DEPOSITS

ENCHONDROMA

OR EXOSTOSIS CONSISTS OF A BENIGN PROJECTION OF BONE THAT HAS A CARTILAGINOUS CAP

OSTEOCHONDROMA

OSTEOCHONDROMA IS ALSO KNOWN AS

EXOSTOSIS

HEY ARE GENERALLY FOUND IN THE METAPHYSIS OF LONG BONES, THE RIBS, AND THE PELVIS

OSTEOCHONDROMAS

OFTEN PRODUCE A MUSHROOM OR CAULIFLOWER RADIOGRAPHIC APPEARANCE AND ARE SOMETIMES REFERRED TO AS A BONE SPUR.

OSTEOCHONDROMAS

THIS IS THE MOST COMMON TYPE OF PRIMARY, MALIGNANT BONE TUMOR.

MULTIPLE MYELOMA

IT IS CHARACTERIZED BY AN INCREASE IN PLASMA CELLS WITHIN RBC PRODUCING BONES

MULTIPLE MYELOMA

ARE IMMUNE SYSTEM CELLS THAT ARE FOUND IN THE BONE MARROW AND PRODUCE ANTIBODIES.

PLASMA CELLS

THE CARDINAL SIGNS OF MULTIPLE MYELOMA ARE

POSSESS "MULTICENTRIC" OR "PUNCHED-OUT" OSTEOLYTIC LESIONS. BENCE-JONES PROTEINS ARE FOUND IN THE URINE. POSSESS MARKED OSTEOPOROSIS WITH COMPRESSION FRACTURES OF THE VERTEBRAL BODIES

SINCE THERE IS NO CURATIVE TREATMENT FOR MULTIPLE MYELOMA, TREATMENT IS FOCUSED ON

SUPPRESSION AND CONTAINMENT.

• REMISSION WITH MULTIPLE MYELOMA CAN BE INDUCED WITH THE USE

CHEMOTHERAPY, STEM CELL TREATMENT, AND STEROIDS

A IS THE SECOND MOST COMMON TYPE OF MALIGNANT BONE TUMOR. • THIS IS AN OSTEOBLASTIC LESION THAT MAY EXTEND INTO THE SURROUNDING SOFT TISSUE STRUCTURES.

OSTEOSARCOMA