Questions and Answers
What is the most common bacterium involved in osteomyelitis?
Staphylococcus
What is the primary reason for immobility in osteomyelitis patients?
Severe pain
What is the most reliable diagnostic test for osteomyelitis in the early stages?
MRI
What is the primary laboratory finding in osteomyelitis patients?
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What is the characteristic radiographic finding in osteomyelitis patients in the later stages?
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What is the typical clinical feature of osteomyelitis?
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What is the primary component of the bone matrix?
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Which type of bone disease is characterized by softening of the bones in children?
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What is the term for the process of bone formation?
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Which type of bone tumor is characterized by the presence of giant cells?
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What is the term for the inflammation of the bone and bone marrow secondary to bacterial infection?
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Which type of bone disease is characterized by a defect in the synthesis of collagen?
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What is the term for the abnormal curvature of the spine?
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Which type of bone tumor is malignant and typically occurs in the metaphysis of long bones?
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What is osteoporosis characterized by?
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What is the primary cause of postmenopausal osteoporosis?
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What is a possible environmental factor that contributes to osteoporosis?
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What is a common symptom of osteoporosis?
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What is a complication of osteoporosis?
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Which of the following is NOT a possible cause of osteoporosis?
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What is the primary location where bacteria colonize in hematogenous osteomyelitis?
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What is the result of occlusion of blood supply in osteomyelitis?
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What is the characteristic of chronic osteomyelitis?
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What is the complication of untreated osteomyelitis?
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What is the term used to describe the elevation of periosteum in osteomyelitis?
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What is the primary source of bacteria in hematogenous osteomyelitis?
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What is the result of the abscess extending into the adjacent joint area in osteomyelitis?
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What is the term used to describe the dead bone in osteomyelitis?
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What is the primary age range affected by osteosarcoma?
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What is a genetic predisposition associated with osteosarcoma in children?
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What is a common etiological factor associated with adult osteosarcoma?
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What is the typical gross appearance of osteosarcoma?
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What is the common location of osteosarcoma in long bones?
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What is the common mode of metastasis in osteosarcoma?
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What is the characteristic feature of osteosarcoma in terms of bone and cartilage formation?
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What is the significance of the tumor location in the distal femoral metaphysis?
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Study Notes
Bone Diseases
- Bone diseases can be classified into neoplasms, congenital, infections, metabolic bone diseases, and uncertain causes.
Congenital Bone Diseases
- Achondroplasia: a congenital bone disease
- Osteogenesis imperfecta (Brittle Bone Disease): a congenital bone disease
Infections
- Osteomyelitis: an acute inflammation of the bone and bone marrow, secondary to bacterial infection
- Routes of infection: hematogenous, direct implantation, and continuous source
- Pathogenesis of osteomyelitis: local ischemia, necrosis, and sequestrum formation, elevation of periosteum, and abscess extension into adjacent joint area or medullary cavity
Acute Pyogenic Osteomyelitis
- Clinical features: high fever, throbbing pain, swelling, and immobility
- Laboratory findings: increased neutrophil, TWBC, C-reactive protein, and ESR, and positive blood culture for Staph sp. in 70% of patients
- Radiography: normal in early-onset, bone necrosis in later stage with areas of lucency
Chronic Osteomyelitis
- Hematogenous osteomyelitis: can cause gangrene, especially in diabetic patients
- Clinical features: high fever, throbbing pain, swelling, and immobility
- Laboratory findings: increased neutrophil, TWBC, C-reactive protein, and ESR, and positive blood culture for Staph sp. in 70% of patients
- Radiography: normal in early-onset, bone necrosis in later stage with areas of lucency
Metabolic Bone Diseases
- Osteoporosis: a form of bone atrophy, loss of total mass without other structural abnormalities
- Etiology: senile osteoporosis, postmenopausal osteoporosis, environmental factors, prolonged immobilization, endocrine disease, and negative calcium balance
- Pathology and clinical features: affects all bones, especially in major weight-bearing and stress areas, kyphosis, abnormal vertebral curvature, decrease in height, and compression fractures
Neoplasms
- Osteosarcoma: the most common malignant tumor of bone, mainly affecting individuals 10-25 years old
- Etiology: childhood osteosarcoma (genetic predisposition, higher incidence in children with retinoblastoma), adult osteosarcoma (radiation exposure, secondary to Paget's disease)
- Pathogenesis: arises in the medullary cavity of the metaphysical region of long bone, caused by germline or sporadic mutations, aggressive and infiltrates widely, and hematogenous metastasis to the lung occurs early
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