What is osteoporosis?
Reduction of bone mass leading to structural changes allowing frequent fractures.
When is osteoporosis recognized?
When 30-40% of bone mass is lost.
What is disuse osteoporosis?
Osteoporosis in immobilized fractures.
What are primary causes of metabolic bone disease?
Postmenopausal, senile, idiopathic.
What are secondary causes of metabolic bone disease?
Endocrine disorders, tumors, malabsorption, malnutrition, Vitamin D deficiency, drugs.
What affects total bone mass?
Physical activity and muscle strength.
What is the age-related loss of bone mass after adulthood?
0.7% per year.
What accelerates bone loss after menopause?
Estrogen deficiency leading to increased osteoclastic activity.
Which part of the skeleton is most affected by osteoporosis?
Vertebral bodies.
What is Paget's disease also called?
Osteitis deformans.
What happens in Paget's disease?
Excessive bone resorption followed by heightened deposition.
What is the morphology of Paget's disease?
Mosaic pattern on histology of lamella bone.
What is Ricketts?
Defective mineralization of bone in children due to lack of vitamin D.
What is osteomalacia?
Defective mineralization of bone in adults due to lack of vitamin D.
What causes Ricketts and osteomalacia?
Inadequate synthesis or dietary vitamin D, malabsorption, end organ resistance, phosphate depletion.
What are clinical features of Ricketts?
Craniotabes, frontal bossing, squared head appearance, rachitic rosary.
What is Harrison's groove associated with?
Lower margin cage of rib
What is lumbar lordosis?
Bowing of legs
What does osteoid bone look like in adults?
Weak to stress and micro fractures
What is osteomyelitis?
Infection of bone and marrow
What type of infection is more common in osteomyelitis?
Pyogenic (bacterial)
What organism is responsible for 80-90% of osteomyelitis infections?
Staph aureus
Which organisms can cause osteomyelitis?
E. coli, Pseudo, Klebsiella
What type of infections do sickle cell patients have?
Salmonella infections
What affects the location of osteomyelitis?
Vascularization of the bone
What is the disease location in neonates for osteomyelitis?
Metaphyses and epiphyses
What is the disease location in adults for osteomyelitis?
Epiphyses and subchondral areas
What characterizes acute osteomyelitis morphology?
Acute inflammation with necrosis
What can form due to osteomyelitis reaching the periosteum?
Subperiosteal abscess
What is dead bone referred to in osteomyelitis?
Sequestrum
What is Brodie's abscess?
Small intraosseous abscess
What is sclerosing osteomyelitis of Garre?
Extensive new bone formation in the jaw
What are common symptoms of acute osteomyelitis?
Fever, chills, leucocytosis
What is necessary for diagnosing osteomyelitis?
X-rays showing lytic area with sclerosis
What percentage of osteomyelitis cases may fail to resolve?
5 to 20%
What can chronic osteomyelitis lead to?
Acute flare-ups after dormancy
What is the incidence of bone disease in TB patients?
1 to 3%
What is the common site for TB infections?
Thoracic and lumbar vertebrae
What is a common symptom of spinal TB?
Pain on motion and localized tenderness
What is the most common chronic joint disease?
Osteoarthritis
What type of disorder is osteoarthritis?
Degenerative disorder of the elderly
What is the commonest chronic joint disease?
Osteoarthritis
Is osteoarthritis an inflammatory disorder?
No, it is a degenerative disorder.
What joints are mainly affected by osteoarthritis?
Knee, hip, cervical and lumbar spine.
What is a familial feature of osteoarthritis?
Generalised disease affecting females with interphalangeal osteophytes.
What symptom is relieved by rest in osteoarthritis?
Pain
What are common clinical features of osteoarthritis?
Stiffness and crepitus on movement.
What gait is observed if the hip bone is affected in osteoarthritis?
Antalgic gait
What is the end result of joint damage in osteoarthritis?
Change in articular cartilage and underlying bone.
What early change occurs in the cartilage in osteoarthritis?
Loss of proteoglycans.
What happens to bone in advanced osteoarthritis?
Bone becomes smooth (eburnation) and may develop grooves.
What are osteophytes?
Outgrowths of proliferating cartilage that undergo endochondral ossification.
What is rheumatoid arthritis?
An autoimmune systemic inflammatory disease mainly affecting joints.
What percentage of the adult population is affected by rheumatoid arthritis?
1%
What is the gender ratio for rheumatoid arthritis?
Female to male ratio is 3:1.
What joints are mainly affected in rheumatoid arthritis?
Metacarpo-phalangeal joints, shoulders, and knees.
What is the seropositivity rate for rheumatoid factor in rheumatoid arthritis?
85% are sero-positive.
What do immune complexes provoke in rheumatoid arthritis?
An inflammatory response with synovial hyperplasia.
What is pannus in rheumatoid arthritis?
Granulation tissue that may grow over the articular surface.
What deformities are associated with rheumatoid arthritis?
Ulnar deviation, boutonniere, and swan neck deformities.
What are rheumatoid nodules?
Subcutaneous nodules over extensor surfaces, indicating aggressive disease.
What is a rare extra-articular manifestation of rheumatoid arthritis?
Vasculitis with fibrinoid necrosis of vessel wall.
What indicates more aggressive disease in patients?
Its presence indicates more aggressive disease.
What is VASCULITIS?
A condition involving inflammation of blood vessels.
What is a characteristic of arteritis in vasculitis?
Fibrinoid necrosis of vessel wall.
In which patients is arteritis usually seen?
Usually seen in seropositive patients.
What may be seen in nail folds of patients with vasculitis?
Splinter hemorrhages.
What may vasculitis present as?
Gangrene of digits or viscera.
What neurological issue may vasculitis cause?
Peripheral neuropathy.
What other sites can vasculitis affect?
Cardiac, pulmonary, eye, etc.
What age group is the juvenile form of vasculitis seen in?
Under 6 years, especially 1 to 3 years.
What are the three main categories of conditions summarized?
What is osteoporosis?
Reduction of bone mass leading to structural changes allowing frequent fractures.
What are secondary causes of metabolic bone disease?
Endocrine disorders, tumors, malabsorption, malnutrition, Vitamin D deficiency, drugs.
What accelerates bone loss after menopause?
Estrogen deficiency leading to increased osteoclastic activity.
What causes Ricketts and osteomalacia?
Inadequate synthesis or dietary vitamin D, malabsorption, end organ resistance, phosphate depletion.
What are clinical features of Ricketts?
Craniotabes, frontal bossing, squared head appearance, rachitic rosary.
What is a familial feature of osteoarthritis?
Generalised disease affecting females with interphalangeal osteophytes.
What is the end result of joint damage in osteoarthritis?
Change in articular cartilage and underlying bone.
What happens to bone in advanced osteoarthritis?
Bone becomes smooth (eburnation) and may develop grooves.
What joints are mainly affected in rheumatoid arthritis?
Metacarpo-phalangeal joints, shoulders, and knees.
What is the seropositivity rate for rheumatoid factor in rheumatoid arthritis?
85% are sero-positive.
What do immune complexes provoke in rheumatoid arthritis?
An inflammatory response with synovial hyperplasia.
What is pannus in rheumatoid arthritis?
Granulation tissue that may grow over the articular surface.
What deformities are associated with rheumatoid arthritis?
Ulnar deviation, boutonniere, and swan neck deformities.
What are rheumatoid nodules?
Subcutaneous nodules over extensor surfaces, indicating aggressive disease.
What is a rare extra-articular manifestation of rheumatoid arthritis?
Vasculitis with fibrinoid necrosis of vessel wall.
What are the three main categories of conditions summarized?
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