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MSK > Bone diseases > Flashcards

Bone diseases Flashcards

1
Q

What are the two necrotising bone diseases we need to know?

A 
Osteochondritis 
Avascular Necrosis (AVN)
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2
Q

What is osteochondritis?

A

Inflammation of bone/cartilage due to interrupted blood supply leading to necrosis.

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3
Q

What causes the interrupted blood supply in osteochondritis?

A

Repeated movement or traction injury compressing blood vessels.

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4
Q

What are some of the signs osteochondritis can cause?

A

Compression and fragmentation of bone (osteochondritis dissecans)
Separation from periosteum
Pain

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5
Q

What are the common sites for osteochondritis to present?

A 
2nd metatarsal 
Navicular
Lunate
Capitellum of elbow
Perthes disease in hip
Often occurs at apophysis (where tendons attach)
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6
Q

How do you treat osteochondritis?

A

Pin
Osteotomy
Remove fragments

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7
Q

What group is most affected by osteochondritis?

A

Children

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8
Q

What is avascular necrosis?

A

Ischemic necrosis of bone

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9
Q

What are the common sites to find avascular necrosis?

A

Femoral head and condyles, head of humerus, capitellum, scaphoid, talus

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10
Q

What are common causes of avascular necrosis?

A

Idiopathic, fractures, thrombophilia, sickle cell, SLE, decompression sickness, alcohol, steroids, hyperlipidemia (last 3 due to fat sludging up vessels)

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11
Q

How do you diagnose and treat avascular necrosis?

A

Early- MRI and decompress bone

Late- Damage done therefore replace.

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12
Q

What are the five biochemical diseases of bone we need to know?

A 
Osteoporosis
Osteomalacia and Rickets
Hyperparathyroidism
Renal Dystrophy
Paget's Disease
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13
Q

What is osteoporosis?

A

Decreased bone mineral density and increased porosi weakens bone.
2.5 standard deviations less than mean peak for race and sex.
Occurs naturally as part of aging.

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14
Q

What is osteopenia?

A

A milder form of osteoporosis. 1-2.5 deviations left.

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15
Q

What are the two types of osteoporosis?

A

Type 1- Post menopausal

Type 2- Occurs due to aging

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16
Q

What are some risk factors for developing osteoporosis?

A

Smoking, alcohol, poor diet, inactivity, lack of VD.

17
Q

How do you diagnose osteoporosis?

A

DEXA scanning for bone density.

Serum Ca and P must be normal.

18
Q

How do you treat osteoporosis?

A

Cannot restore bone density but Ca and VD supplements, bisphosphonates, denosumab and strontium can slow the disease.

19
Q

What is osteomalacia and rickets?

A

Softening of bone cue to lack of Ca and P.

20
Q

What age group is osteomalacia found in?

A

Adults

21
Q

What age group is rickets found in?

A

Children

22
Q

What causes osteomalacia/rickets?

A

Lack of dietary Ca, insufficient VD or P loss due to kidney disease (refeeding syndrome, alcohol, anticonvulsants)

23
Q

What are the symptoms of osteomalacia/rickets?

A

Bone pain, deformities, multiple fractures, hypocalcemia, (muscle cramps, fatigue, brittle nails), abnormal blood chemistry (decreased Ca and P, increased ALP)

24
Q

What is the treatment for osteomalacia/rickets?

A

VD therapy and Ca/P supplements

25
Q

What is hyperparathyroidism?

A

Overactive parathyroid glands produce increased PTH.

26
Q

What are the three forms of Hyperparathyroidism?

A

Primary- Benign adenoma or hyperplastic disorder
Secondary- Physiological over production due to hypocalcemia
Tertiary- Chronic secondary who develop adenoma.

27
Q

How does hyperparathyroidism present?

A

Fatigue, depression, bone pain, thirst, renal stones, fragine bones and lytic lesions.

28
Q

How do you diagnose hyperparathyroidism?

A

Increased serum PTH and Ca. Low or normal P.

29
Q

How do you treat hyperparathyroidism?

A

Remove adenomatous gland and treat underlying cause.

30
Q

What is renal dystrophy?

A

CKD -> Decrease P excretion and VD activation -> Secondary HPTism -> Osteomalacia.

31
Q

What is Paget’s Disease?

A

Excessive osteoclast activity leads to increased bone turnover which doesn’t remodel.

32
Q

What causes Paget’s Disease?

A

Viral infection and genetics.

33
Q

What bones are commonly affected by Paget’s Disease?

A

Pelvis, femur, skull, tibia and ear ossicles.

34
Q

What does Paget’s disease do to bone?

A

Thickened, brittle and misshapen bones.

35
Q

How does Paget’s disease present?

A

Can be asymptomatic or cause arthritis, fractures, deformities, pain and cardiac failure.

36
Q

What age group does Paget’s Disease usually affect?

A

50-70 YO

37
Q

How do you detect Paget’s Disease?

A

Increased serum ALP, normal serum Ca and P. XR

38
Q

How do you treat Paget’s Disease?

A

Bisphosphonates or calcitonin. Joint replacement and fracture repair.

MSK (17 decks)

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