Abnormal Fracture Healing in Bone Pathology
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Questions and Answers

What is a common cause of metabolic bone disease?

  • Hyperparathyroidism
  • Rheumatoid arthritis
  • Osteoporosis (correct)
  • Vitamin D deficiency

Which condition is characterized by abnormal bone remodeling?

  • Rickets
  • Osteopenia
  • Paget disease (correct)
  • Osteogenesis imperfecta

Which type of tumor can be associated with bone disease?

  • Sarcoma
  • Benign or malignant tumors (correct)
  • Lymphoma
  • Melanoma

Which of the following is NOT a cause of metabolic bone disease?

<p>Hemophilia (C)</p> Signup and view all the answers

What type of disease is Paget disease considered to be?

<p>Metabolic (B)</p> Signup and view all the answers

What characterizes a pathological fracture?

<p>It arises spontaneously or from minor trauma. (B)</p> Signup and view all the answers

What is typically found in the space between the ends of a fractured bone?

<p>Fluid (B)</p> Signup and view all the answers

How does a pathological fracture differ from other types of fractures?

<p>It occurs through abnormal bone, not necessarily due to high-force injury. (B)</p> Signup and view all the answers

In the context of fractures, what does the term 'abnormal bone' refer to?

<p>Bone affected by disease or condition. (B)</p> Signup and view all the answers

Which statement about pathological fractures is true?

<p>They can occur without any preceding trauma. (D)</p> Signup and view all the answers

Which of the following is NOT a suspected mechanism causing osteonecrosis?

<p>Chronic inflammation (B)</p> Signup and view all the answers

What is a common site affected by avascular necrosis?

<p>Head of the femur (B)</p> Signup and view all the answers

Which of the following is a possible cause of bone ischemia?

<p>Vasculitis (D)</p> Signup and view all the answers

What percentage of osteonecrosis cases have an unknown cause?

<p>25% (C)</p> Signup and view all the answers

Which type of drugs is commonly associated with causing osteonecrosis?

<p>Corticosteroids (B)</p> Signup and view all the answers

What generally protects the cortex from being affected during an infarct?

<p>Collateral blood supply (D)</p> Signup and view all the answers

During which age range does the peak incidence of infarcts occur?

<p>30s to 50s years (D)</p> Signup and view all the answers

What factors influence the symptoms experienced by a patient after an infarct?

<p>Location and extent of infarct (C)</p> Signup and view all the answers

Which statement is true regarding the infarct and its impact on the body?

<p>Collateral blood supply may mitigate cortical damage (B)</p> Signup and view all the answers

Infarcts primarily impact which tissue when collateral blood supply is present?

<p>White matter (C)</p> Signup and view all the answers

What does osteonecrosis refer to?

<p>Infarction of trabecular bone and marrow cells (A)</p> Signup and view all the answers

Which of the following conditions is not directly associated with osteonecrosis?

<p>Hyperemia (D)</p> Signup and view all the answers

Which of the following best describes the underlying cause of osteonecrosis?

<p>Reduced blood flow leading to cell death (D)</p> Signup and view all the answers

In the context of bone conditions, which option describes a characteristic of osteonecrosis?

<p>It involves ischemic necrosis of trabecular bone. (A)</p> Signup and view all the answers

Which type of bone tissue is primarily affected by osteonecrosis?

<p>Trabecular bone (C)</p> Signup and view all the answers

What type of tumors are discussed in the content?

<p>Soft tissue tumors (B)</p> Signup and view all the answers

Which resource is specifically referenced in the content?

<p>Robbins and Cotran Pathologic Basis of Disease (C)</p> Signup and view all the answers

What is the range of pages for the chapter covering bones, joints, and soft tissue tumors?

<p>1273 to 1292 (B)</p> Signup and view all the answers

Which of the following best describes the content focus?

<p>Tumors of bones and soft tissues (C)</p> Signup and view all the answers

What is the significance of the YouTube link provided in the resources?

<p>It offers a visual summary of the chapter content (D)</p> Signup and view all the answers

Flashcards

Pathological Fracture

A fracture that occurs in weakened bone due to a disease process, often with minimal or no trauma.

Causes of Pathological Fractures

Conditions like osteoporosis, bone cancer, or infections can weaken bones and make them susceptible to fractures.

Pathological Fractures vs. Normal Fractures

Normal fractures require significant force, while pathological fractures happen with minimal or no force due to pre-existing weakened bone.

Signs of a Pathological Fracture

Pain, swelling, tenderness, and deformity at the fracture site are common signs.

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Treatment of Pathological Fractures

Treatment often involves surgery or immobilization depending on the cause and severity of the fracture.

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Metabolic Bone Disease

A condition that affects bone metabolism, leading to weakened bones and increased fracture risk.

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Paget Disease

A chronic bone disease characterized by abnormal bone turnover and remodeling, which can weaken bones and increase fracture risk.

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Tumors and Fractures

Both benign and malignant tumors can weaken bone, leading to increased fracture risk, even with minimal trauma.

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Key Causes of Pathological Fractures

Metabolic bone disease (osteoporosis), Paget disease, and bone tumors are common causes of pathological fractures.

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What is Osteonecrosis?

Osteonecrosis, also known as avascular necrosis, is the death of bone tissue due to a lack of blood supply.

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What are the main causes of Osteonecrosis?

Common causes include vascular injury, drugs (like corticosteroids), systemic diseases (like sickle cell), radiation, and sometimes the cause is unknown.

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What are the 3 mechanisms suspected to cause Osteonecrosis?

The three proposed mechanisms are: mechanical disruption of blood vessels, thrombotic occlusion (blood clots blocking vessels), and extravascular compression (pressure on vessels from outside).

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Where does Osteonecrosis commonly affect?

Avascular necrosis frequently affects the ends of long bones like the femur, humerus, knees, shoulders, ankles, and jaw.

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What are some classical sites for Osteonecrosis?

Common sites include the head of the femur, neck of the talus, and waist of the scaphoid.

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Cortex Blood Supply

The outer layer of the brain (cortex) is usually protected from damage due to a good blood supply, even in cases of stroke.

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Stroke Peak Incidence

Strokes are most common between the ages of 30 and 50 years old.

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Stroke Symptoms Depend on Location

The symptoms of a stroke depend on which part of the brain is affected by the blocked blood flow.

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Stroke and Infarct

Infarct refers to the tissue death caused by a lack of blood flow, often due to a stroke.

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Stroke and Extent of Damage

The extent of damage caused by a stroke depends on how much brain tissue is affected by the blocked blood flow.

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Osteonecrosis

Death of bone tissue due to lack of blood supply. It's like a heart attack for the bone, causing it to weaken and break easily.

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Causes of Osteonecrosis

Several factors can cause osteonecrosis, including trauma (e.g., fracture, surgery), steroid use, alcohol abuse, and certain diseases like sickle cell anemia.

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Osteonecrosis: Location

Osteonecrosis can occur anywhere in the body, but is most common in the hip, knee, shoulder, and jaw.

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Symptoms of Osteonecrosis

Symptoms of osteonecrosis include pain, stiffness, limited range of motion, and swelling in the affected area.

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Osteonecrosis: Treatment

Treatment for osteonecrosis depends on the severity and location. Options include medications, surgery, or lifestyle modifications.

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Pathological vs. Normal Fractures

Normal fractures require significant force, while pathological fractures happen with minimal or no force due to pre-existing weakened bone.

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Study Notes

Abnormal Fracture Healing

  • Delayed union: Callus formation and bony union occur but are slower than normal.

  • Nonunion: Fracture callus formation is interrupted or incomplete. Bone ends are joined by non-osseous (fibrocartilaginous) tissue.

Pseudoarthrosis (False Joint)

  • If nonunion persists, the malformed callus undergoes cystic degeneration.
  • The luminal surface may become lined by synovial-like cells.
  • The space between fractured bone ends may contain fluid.

Pathological Fracture

  • A pathological fracture is a fracture that occurs either spontaneously or after minor trauma through an area of abnormal bone.

  • Causes:

    • Metabolic bone disease (osteoporosis)
    • Paget's disease
    • Tumors (benign or malignant)
    • Simple bone cyst
    • Metastatic carcinoma and myeloma
    • Infection

Osteonecrosis (Avascular Necrosis)

  • Definition: Osteonecrosis is the infarction (ischemic necrosis) of trabecular bone and marrow cells.

  • The cortex is usually unaffected due to collateral blood supply.

  • Peak incidence: 30s to 50s.

  • Symptoms: Depend on location and extent of infarct. Subchondral infarcts commonly cause pain.

  • Causes of bone ischemia:

    • Vascular injury (trauma, vasculitis)
    • Drugs (corticosteroids)
    • Systemic disease (e.g., sickle cell crisis)
    • Radiation
    • In ~25% of cases, the cause is unknown.

  • Mechanisms causing osteonecrosis:

    • Mechanical disruption of vessels
    • Thrombotic occlusion
    • Extravascular compression

  • Commonly affected areas: Ends of long bones (femur, humerus), knees, shoulders, ankles, and jaw.

  • Classic sites:

    • Head of femur
    • Neck of talus
    • Waist of the scaphoid

  • Image description: Femoral head with a subchondral, wedge-shaped pale yellow area of osteonecrosis (arrow).

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Fracture and Bone Healing (2) PDF

Description

This quiz covers the concepts of abnormal fracture healing, including delayed union, nonunion, pseudoarthrosis, and pathological fractures. It also discusses the causes of these conditions, such as metabolic bone disease and infections. Test your understanding of these important topics in bone pathology.

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