Bone, Joint, and Muscle Pathology Review PDF 2024

Review of Bone, Joint and Muscle Pathology Chaya Prasad, MD, MBA  Developmental and Metabolic Bone Diseases High Yield Content Paget’s Osteopetrosis Osteoporosis Achondroplasia OI Vit D, Vit C  Developmental and Metabolic Bone Diseases Common e...

Review of Bone, Joint and Muscle Pathology Chaya Prasad, MD, MBA  Developmental and Metabolic Bone Diseases High Yield Content Paget’s Osteopetrosis Osteoporosis Achondroplasia OI Vit D, Vit C  Developmental and Metabolic Bone Diseases Common entities (I have mentioned them at start of each topic and in the previous slide) Pertinent pathophys abnormality - e.g collagen type 1 defect in Osteogenesis Imperfecta - e.g FGFR3 receptor in Achondroplasia - e.g Carbonic anhydrase mutation in Osteopetrosis Clinical Presentation - e.g Enlarging hat size or ring size in Paget’s - e.g Blue sclera of OI - e.g features of the rickets child Abnormal Labs - e.g labs of renal osteodystrophy - e.g Paget’s THE diagnostic lab - e.g Dexa scan for osteoporosis Path images - Only from my lectures Associations - e.g Malabsorption in stem – think Vit def  Tumors and Infections of Bone High Yield Content Osteoid osteoma/Osteochondroma/enchondroma Wilms Osteosarcoma Fibrosarcoma Ewing’s Metastatic tumors Osteomyelitis  Know the following for each high yield topic Common entities (I have mentioned them at start of each topic and in the previous slide) Pertinent pathophys abnormality Genetic abnormality - e.g RB germline mutation and osteosarcoma - e.g EWSR1 gene in Ewing's Clinical Presentation - e.g Young person, fractures with minimal trauma, mass lesion – osteosarcoma - Abnormal Labs - THE diagnostic lab - e.g Biopsy for benign and malignant bone tumors Radiologic or pathologic images - Only from my lectures - e.g Sunburst, Codman's triangle – osteosarcoma - e.g Appearance and workup of metastatic bone lesions - histopathologic descriptions Associations - e.g Retinoblastoma and osteosarcoma - e.g Paget’s and osteosarcoma - e.g Li Fraumeni and osteosarcoma  High Yield for Joint Pathology DJD and RA Seronegative arthropathies Gout and Pseudogout Septic arthritis  Know the following for each high yield topic Common entities (I have mentioned them at start of each topic and in the previous slide) Pertinent pathophys abnormality Genetic abnormality - e.g HLA –B27 and ankylosing spondylitis Clinical Presentation - e.g Acute onset joint pain. Warm, tender, after drinking – gout - e.g Pain in early am – RA, - e.g Pain with movement – OA Abnormal Labs - THE diagnostic lab - e.g CCP for RA - e.g Birefringence under polarized light –gout/pseudogout Radiologic or pathologic images - Only from my lectures - histopathologic descriptions Associations - e.g Reiter’s syndrome and GI infections - e.g Chemotherapy induced secondary gout  Muscle pathology Innervation and reinnervation DMD, BMD Congenital myopathy Inflammatory myopathies Mitochondrial myopathies  Know the following: for high yield content Genetic abnormality -e.g dystrophin gene in DMD/BMD Clinical Presentation - e.g waddling gait, hypertrophied calves, Gowers sign – DMD - e.g know differences between DMD/BMD, and DM/PM - e.g everything about SLE Clinical scenarios where they can be encountered - e.g x-linked familial – DMD/BMD Lab test (s) - e.g ATPase stain and infantile SMA - e.g CK, muscle biopsy (dystrophin stain) in DMD/BMD SPECIFIC (diagnostic) lab test - e.g Western blot and genetic assays – DMD/BMD - e.g Myophosphorylase staining in McArdle Pathology - know my images. Associations - e.g Paraneoplastic syndrome and neurogenic myopathies - LES and Small cell CA - Myasthenia Gravis and thymoma  Stems, Images and Labs Stems - Age, HPI, physical findings Images (radiologic and histopathologic) - Can help solidify your DD and definitely final diagnosis Labs - Are they normal or abnormal - Do they solidify your DD and final diagnosis  In summary I do not ask about minutia. Look at big picture content Concentrate on the most common diseases in each category. (I mention those as I start the topic and I have provided a trimmed down list today) Diseases that I have trimmed out will not be questioned by me (on Step yes) I do not show BM or solid organ or whole mount images I do not ask about content form year 1 – no basic physiology I do not ask about treatment modalities. Trimmed down topics is still fair game for other teaching faculty Trimmed down content may show up as distractors, so you need to know them well enough to rule them out. The End