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Pathology Ch 2 The Skeletal System
Terms in this set (54)
abnormality of structure or body part
physical anomaly recognizable at birth
disorder of tissue development
present at birth as a result of genetic or environmental factors
Caused by developmental disorders genetically transmitted from either parent to child due to abnormal genes derived from ancestors
Osteogenesis Imperfecta (OI)
Brittle bone disease, present at birth
OI tarda - presents some years after birth & ceases as adult. Radiographs demonstrates multiple fractures in various stages of healing with decreased bone mass
Most common inherited disorder affecting skeletal system. Results in bone deformity & dwarfism. Short extremities with normal trunk size. Extreme lumbar lordosis, bowed legs, & bulky forehead
"Marble bone". Variety of disorders demonstrating an increase in bone density & defective bone contour.
Bones are heavy and compact, but brittle. Radiographs demonstrate increase in density & thickness of cortex
+ Exposure factors
Albers-Schonberg disease. Common form. Benign skeletal anomaly. Increased bone density with fairly normal bone contour
Group of hereditary diseases . Mainly resulting in abnormal bone contour of cranium & long bones. Presents in childhood. Bony overgrowth may entrap cranial nerves
failure of fingers and/or toes to separate
presence of extra digits
Talipes - congenital malformation of foot (turned in at the ankle). Prevents normal weight bearing. more common in males. may occur bilaterally
Congential Hip Dislocation
Malformation of acetabulum. Head of femur displaces superiorly & posteriorly. Occurs more frequently in females. Most commonly treated with immobilization (casting or splinting affected hip)
Scoliosis - lateral curvature of spine.
Majority are idiopathic.
Greater frequency in females. Radiography is important in diagnosis and treatment
Vertebra takes on characteristic of both vertebrae on each side of a major spine division. Most frequent between T & L spines. 1st lumbar may have rudimentary ribs. C-7 may have cervical rib
Incomplete fusion of the laminae.
Spina bifida occulta (only visible on x-ray).
Severe cases may involve spinal cord or nerve roots
premature closure of any cranial sutures --> cranial anomalies
congenital abnormality: failure of the brain & cranial vault to form --> cranial anomalies
Infection of bone marrow. Caused by pathogenic microorganism spread via bloodstream, from infection within a contiguous site, or through direct introduction of microorganism.
No specific bone changes noted in very early stage.First demonstrated on radiographs as soft tissue swelling in area around the bone. Follow up x-rays 10-14 days after medical treatment. 30-50% loss of bone calcium required before destructive changes are noted on x-rays
--> inflammatory disease
Chronic inflammatory disease of bone. most commonly affects hips, knee, and spine. Ends of bone have "worm eaten" appearance
Tuberculosis of spine. Described in Egyptian mummies. Destroys spine through softening & collapse of vertebrae
"Pyogenic arthritis". Caused by staph, strep, and gonococci. Symptoms include pain, redness, & swelling.
Responds to antibiotics. Early radiographs demonstrate increased joint space, bony destruction, & joint dislocation. Radiographs in healing stage demonstrate recalcification & sclerosis (results in joint ankylosis)
pathologic changes begin in articular cartilage of joints
pathologic changes begin in synovial membrane of joints
Chronic autoimmune disease. Severity may fluctuate.Develops slowly. Progressively destroys cartilage, bone, & surrounding structures. More common in women. Most commonly occurs between 30-40 years.Begins in peripheral joints.
Progresses to cortical erosion with narrowing of joint space. Joints eventually become ankylosed (fused)
Marie-Strumpell disease or "bamboo spine". Progressive form of arthritis mainly involving spine. Joints and articulations become fused (ankylosed).Tends to affect men. Radiographs demonstrate calcification of spine with ossification of vertebral ligaments. Fibrous adhesions develop that lead to bone fusion & calcification of annulus fibrosis
Most common type of arthritis.
"Degenerative joint disease". Both sexes affected. Occurs at 50 years.
Affects large weight bearing joints.
Appears radiographically as narrowing of joint space with osteophytes (bone spurs)
Inflammation of tendon sheath
May cause formation of calcium deposits in tendon or sheath
Deposits in shoulder may cause rotator cuff tears
Inflammation of the bursae
Bursae are found where tendons pass over bony prominences
May thicken walls of bursa & create calcium deposits
Inherited metabolic disease
Excess amounts of uric acid produced & deposited in joints and surrounding bone. More common in men. Most commonly affects MP joint of first toe
Radiographs demonstrate bony erosion with overhanging edges
Caused by a disturbance of the normal physiologic function of the body. Includes endocrine disorders and disturbances of fluid and electrolyte balance
decrease in bone density --> metabolic disease
softening of bones. Lack of calcium in tissues & failure of bone tissue to calcify. Primarily due to inadequate intake or absorption of calcium, phosphorus, or vitamin D.Known as "rickets" if occurrence is prior to closure of growth plates.
Osteopenia & pseudofractures present. --> metabolic disease
Abnormal decrease in bone density.
Results in thinning of cortical bone & enlargement of medullary cavity.
Affects women more often than men. Increased severity can create compression fractures.
Subtractive or destructive pathology.
Decrease exposure technique
Osteitis deformans. Unknown etiology. Common in elderly & affects men more often. Bone undergoes destruction (osteolytic stage) & simultaneous replacement (osteoblastic stage) with soft, poorly mineralized osteoid material
No known cure. Osteoid material is bulky & porous, but its matrix is thicker than normal bone. Radiographs demonstrate cortical thickening with a coarse, thickened trabecular pattern
Common disease of the endocrine system. Creates effect on entire skeletal system. Disruption of calcium-phosphate ratio. May result in bone destruction, causing need to decrease exposure factors
Endocrine disorder caused by pituitary gland disturbance.
Caused by excessive growth hormone
Associated with giantism.
Radiographic studies demonstrate enlarged sella turcica and skull changes. Additive
Vertebral Colum Injures
Whiplash -Direct trauma
Loss of normal lordotic curve
Cleft defect between the superior & inferior articular processes (pars interarticularis). "Broken neck" of Scotty Dog. Result of congenital anomaly & common at L-5.
Demonstrated on oblique L-spine
Forward slippage of the vertebra above on the vertebra below due to spondylolysis
Demonstrated on lateral radiograph of lumbar spine
Results in new, abnormal tissue growth. Leads to formation of either a benign or malignant tumor.
Radiographic studies contribute significantly to diagnosis and management of bone tumor patients
"Exostosis", Most common benign bone tumor. Affects men 3 times that of women. Arises from growth zone on long bones. Bone growth protudes up and away from the nearest joint
Less frequent benign growth. Common in skull. Slow growing.
Can project into the orbits or sinuses
Slow growing benign tumor composed of cartilage. Commonly affects small bones of hands and feet in patients between 30-40 yrs.
Appears as radiolucent lesions containing small, stippled calcifications
Simple Bone Cysts
Wall of fibrous tissue filled with fluid.
Frequently occurs in long bones of children (ages 3 to 14-15).
Radiolucent appearance on x-ray with well-defined margins from normal bone surrounding the lesion
May cause a pathologic fracture
Common small, benign tumor of the skeletal system. Occurs more often in men before 30 yrs. Most commonly found in femur, tibia or spine.
Demonstrated as small radiolucent area on x-ray surrounded by very dense, sclerotic bone.
Common large, benign tumors of the skeletal system. Frequently involve the spine. Not associated with bony reaction. May undergo malignant transformation
Giant Cell Tumor GCTs - numerous multinucleated orthoclastic cells
50% are benign - 35% can recur -
15% are malignant
Equally affects both sexes. Noted in ages 20-30. Radiographic appearance:Thin bone, Classic "soap bubble", Located in epiphysis
"Osteogenic Sarcoma". Except for myeloma, the most common primary malignancy of the skeleton. Most often in the metaphyses of long bones.
50% effects knee
75% of patient under 20 yrs.
Etiology unknown with poor prognosis.
Patient may loose limb due to tumor excision
Primary malignant bone tumor arising from medullary canal. Affects patients age 5 to 15. More common in boys. Affects extremities & pelvis. Lesions undergo bone formation early & destruction in later stage (new bone formed on surface). Appear as "onionskin" or laminated on x-rays
Any type of cancers can metastasize to bone. Metastatic disease from carcinomas is most common malignant tumor of skeleton
Spine is the most common site for metatasis to occur. Nuclear Medicine is best for imaging metastasis.
Radiographically, metastatic tumors can alter bone density and architecture
80 - skull, spine, ribs/sternum
126 - upper/lower extremities
THIS SET IS OFTEN IN FOLDERS WITH...
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