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Pathology

Skeletal

TermDefinition
skeletal system 206 bones 98% calcium, 75% phosphorus
Axial skeleton 80 bones
appendicular skeleton 126 bones
compact bone outer portion of bone
medullary canal made up of cancellous bone, inner portion, bone marrow
diploe separates the inner and outer layers of the compact bone
osteoblasts bone forming cells, bone growth and thickening, regeneration, ossification
osteoclasts cells that break down bone to enlarge the medullary canal and allow for bone growth
diaphysis shaft portion of bone. primary site for ossification
epiphysis expanded end portion, secondary site of ossification
metaphysis growth zone between the epiphysis and diaphysis
fibrous (synarthrodial) immovable joints (skull sutures)
cartilaginous (amphiarthrodial) slightly movable (vertebrae joint)
synovial (diarthodial) free moving (knee)
osteogenesis imperfecta OI brittle bone disease, Type 1 is most mild, repeated fractures, severe osteoporosis, healing fractures with large callus, general decrease in bone mass, thin porous cortex
osteogenesis imperfecta congenita (OI) fractures present at birth, limb deformities and dwarfism, may lead to death
osteogenesis imperfecta tarda (OI) fractures might not appear for years after birth and then generally stop once adulthood is reached,
achondroplasia inherited disorder affecting the skeletal system, bone deformity and dwarfism (no more than 4 ft tall), extreme lumbar lordosis, bowed legs, large head with bulging forehead, midface hypoplasia
osteopetrosis marble bone, increase in bone density and defective bone contour (skeletal modeling)
Albers-Schonberg disease (osteopetrosis) increased bone density with normal bone contour, asymptomatic
craniotubular dysplasias abnormal or defective bone contour of the cranium and long bones
syndactyly failure of the fingers or toes to separate, webbed digits
polydactyly presence of extra digits
clubfoot malformation of the foot weight-bearing, turned inward at the ankle, common in males
developmental dyspepsia of the hip congenital hip dysplasia, malformation of the acetabulum, head of the femur is displaced superiorly and posteriorly, common in females
Scoliosis lateral curvature of the T spine, T spine to the right and L spine to the left, idiopathic, bracing for curves 25-35 degrees, surgical at 40 degrees, common in females, hereditary
transitional vertebra vertebrae may have ribs C7 and L1, congenital
spina bifida incomplete closure of the vertebral canal in the Lumbosacral area, defects of herniations such as a meningocele or myelomeningcele, large boney defects. absence of laminae, increased interpedicular distance
craniosynostosis premature or early closure of any of the cranial sutures, overgrowth of unfused sutures to accommodate brain growth and alters the shape of the head
anencephaly brain and cranial vault do not form, results in death after birth and diagnosed before birth by ultrasound
osteomyelitis infection of the bone and bone marrow caused by pathogenic microorganism spread bloodstream, low grade fever, localized warmth, swelling, dull pain, needs 30-50% bone less is needed to appear on xray, Nuclear Med and MRI is best , diabetics are increased
staphylococcus aureus lowered resistance to the pathogenic organism
sequestrum dead bone that appears very dense
involucrum shell of new supporting bone laid down by the periosteum around the sequestrum
tuberculosis chronic inflammatory disease, shows "worm eaten" bone
Pott disease tuberculosis of the spine
arthritis joint inflammation
psoriatic arthritis inflammatory arthritis associated with psoriasis of the skin, affects mostly DIP joints of hand and feet, stiff and swelling of joints, chronic, genetic and environmental
rheumatoid arthritis chronic autoimmune disease that fluctuates in severity, overgrowth of synovial tissue, erosion of cartilage, scarring and ankyloses (fusion), xray shows early soft tissue swelling over joint, periarticular osteoporosis, narrowing of joint spaces
Juvenile rheumatoid arthritis still disease, affects kids under 16 , pain for 6+ weeks, Pauicartiulaer most common
reiter syndrome young males, bacterial infections of the gastrointestinal and genital systems, variant of rheumatoid arthritis
ankylosing spondylitis progressive from of arthritis (mostly spine), 20-40 years old, Marie-Strumpell disease, Bamboo spine, Begins in SI joints, progress from lumbar spine, ossification of paravertevbral tissues and ligaments w boney bridges, blood tests
osteoarthritis degenerative joint disease, disease of cartilage, inflammatory or erosive and destructive, most common type of arthritis, degenerative joint disease. Primary- normal wear and tear, secondary- trauma
osteophytes bone spurs
gouty arthritis (Gout) excess amounts of uric acid are produced and deposited in the joint and bone, inherited metabolic, MTP joint of the great toe, tophi- large masses of sodium urate crystalline deposits in the joints and other site, over hanging edges
tendonitis inflammation of a tendon
tenosynovitis inflammation of the tendon and the sheath
bursitis bursa gets inflamed
ganglion cystic swelling the develops in connection with a tendon sheath in any joint space
whiplash soft tissue neck injuries
spondylolisthesis symptoms close to a herniated disk, L5-S1, anterior slipping, MRI, CT, Myelography, broken neck on scottie dog
spondylolysis erosion of vertebral bodies
chondrosarcomas bone tumors involve the trunk, shoulder girdle, proximal long bones
osteochondroma most common benign bones tumor, arises from area of metaphysis, protrudes up and away from nearest joint, increase bone density, asymptomatic
exostoses excessive bone growth
osteoma less benign growth located in the skull , slow growing
hyperostosis frontalis interna osteoma of the skull
simple unicameral bone cyst wall of fibrous tissue filled with fluid, appear as radiolucent, diagnosed to pain or pathologic fracture
aneurysmal bone cyst idiopathic condition and not a true neoplasm, occur in the metaphysis of long bones under the age of 20
osteoid osteoma (less than 2cm) and osteoblastoma (larger) common benign tumors
giant cell tumors presence of numerous giant cells
osteoclastomas benign, ages of 20-30 ,a ffect the ends of long bones
osteosarcoma arises from osteoblasts. primary malignancy, common primary malignancy except for myeloma, 75% occur in patients younger than 20, highly aggressive, sunburst due to spicules radiating from primary site
ewing sarcoma primary malignant bone tumor, tumor happens at a younger age 5-15, arises from medullary canal and can affect entire shaft of long bones, rare, 2nd most common highly malignant primary bone tumor of childhood, extremely malignant, onionskin appearance
chondrosarcoma malignant tumor of cartilaginous and composed of atypical cartilage, less common, later age , 5 year survival rate of 40%
bone quality change - bone not as dense change kVp
bone quantlty change change mAs
soft tissue show clues to diagnosis
Magnetic resonance best for soft tissue and joints
Nuclear Medicine can see entire body at one time and differentiation of old and new injuries
osteoporosis deficiency of bone matrix, decrease in technique
enchondroma slow growing benign tumor of hyline cartilage, bubbly lesions, pathological fracture, grows in marrow space
skeletal metastases metastatic disease from carcinomas, most common malignant tumor of skeleton, found due to pain or pathological fracture, bones containing red marrow (spine common), Nuc Med, primary sites for metastasis breasts, lung, prostate, kidney, thyroid and bowel