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PANCE Pearls Musculoskeletal
PANCE Pearls Musculoskeletal
125
Medical
Graduate
07/13/2018

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Term
abducted, externally rotated, squared off shoulder
Definition
anterior glenohumeral shoulder dislocation
Term
groove on humeral head
Definition
Hill-Sachs lesion (compression fracture)
Term
glenoid inferior rim fracture
Definition
Bankart lesion
Term
forced adduction, internal rotation, associated with seizures, electric shock, taruma
Definition
posterior glenohumeral shoulder dislocation
Term
injury to supraspinatus, infraspinatus, teres minor or subscapularis, common in athletes or laborers performing repetitive overhead movements, anterior deltoid pain
Definition
rotator cuff injury (mc supraspinatus)
Term
inflammation associated with \subacromial bursitis, mc in adolescents, <40y
Definition
tendonitis of rotator cuff
Term
supraspinatus strength test
Definition
empty can test (roator cuff)
Term
elbow/shoulder flexed at 90 deg w sharp anterior shoulder pain w internal rotation
Definition
hawkins test, impingement test of subscapular nerve/supraspinatus (roator cuff)
Term
pain with inability to lift arm above shoulder level or hold it or severe pain when slowly lowering the arm after the shoulder is abducted to 90 deg
Definition
drop arm test for impingement of subscapular nerve/supraspinatus (roator cuff)
Term
arm fully pronated (thumbs down) w pain during forward flexion (while shoulder is held down to prevent shrugging)
Definition
neer test , supraspinatus test: pain w abduction against resistance. impingement tes of subscapular nerve/supraspinatus (roator cuff)
Term
may help distinguish tendinopathy from tears in rotator cuff test
Definition
subacromial lidocaine test. normal strength w pain relief = tendinopathy. persistent weakness seen w large tears
Term
shoulder pendulum/wall climbing exercises is treatment for
Definition
tendinitis
Term
direct blow to an adducted shoulder, pain lifting arm
Definition
acromioclavicular joint dislocation (shoulder separation)
Term
treatment includes brief sling immobilization
Definition
acromioclavicular joint dislocation
Term
common site for pathologic fractures in metastatic breast cancer
Definition
proximal humerus/humeral head fractures
Term
direct blow to arm, arm held in adducted position, check deltoid sensation, fall on outstretched hand
Definition
proximal humerus/humeral head fracture (want to rule out brachial plexus or axillary nerve injury)
Term
direct trauma, must rule out radial nerve injury, fall on outstretched hand
Definition
humeral shaft fracture (injury may cause wrist drop)
Term
most commonly fractured bone in children, adolescents & newborns during birth
Definition
clavicle fractures. mc in males, children <2 suspect abuse
Term
shoulder stiffness due to inflammation, especially w DM, hyopothyroidism. mc 40s-60s
Definition
adhesive capsulitis- frozen shoulder, dec ROM esp w external rotation
Term
idiopathic compression of brachial plexus (95%), subclacian vein or subclavian artery. narve compression/pain on ulnar side of hand. swelling w abduction of arm. loss of radial pulse w head rotated to affected side
Definition
thoracic outlet syndrome
Term
adson
Definition
loss of radial pulse w head rotated to affected side
Term
fall on outstretched hand w hyperextended elbow, swelling, tenderness at elbow, abnormal anterior humeral line, nondiplaced->displaced anterior fat pad sign or pos posterior fat pad sign (hemarthrosis)
Definition
supracondylar humerus fracture
Term
supracondylar fracture in children or radial head fracture in adults finding
Definition
anterior/posterior fat pad
Term
has complication of median nerve and brachial artery injury (Volkmann ischemic contracture)- claw-like desormity from ischemia w flexion/contracture of wrist, radial nerve injury
Definition
supracondylar humerus fracture
Term
supracondylar humerus fracture management
Definition
immediate orthopedic consult
Term
fall on outstretched ahnd, usually intraarticular, inability to fully extend the elbow, pos fat pad or displaced anterior fat pad
Definition
radial head fractures
Term
infection of the flexor tendon synovial sheath of finger, mc staph aureus. Kavanel's signs (finger held in flexion, length of tendon sheath is tender, enlarged finger, xtension of the finger causes pain- FLEX)
Definition
suppurative flexor tensynovitis
Term
direct blow, fall on a flexed elbow, inability to extend the elbow, ulnar nerve dysfunction
Definition
olecranon fracture
Term
abrupt goose egg swelling, limited ROM with flexion
Definition
olecranon bursitis
Term
direct blow, may present w localized pain and swelling, from fights
Definition
ulnar shaft (nightstick) fracture
Term
proximal ulnar shaft fracture with an anterior head dislocation, possible radial nerve injury/wrist drop
Definition
monteggia fracture
Term
mid-distal radial shaft fracture with dislocation of DRUJ, fall on outstretched hand or direct blow, unstable
Definition
galeazzi fracture
Term
lifting/swinging/pulling a child while the forearm is pronated and extended-> radial head wedged into the stretched annular ligament. children present w arm slightly flexed, refuse to use arm. put pressure on radial head w supination and flexion
Definition
radial head subluxation (nursemaid's elbow)
Term
radial styloid fracture aka chauffeur's fracture
Definition
hutchinson fracture
Term
lateral elbow pain especially with gripping, forearm pronation and wrist extension against resistance, inflammation of the tendon insertion of extensor carpi radialis brevis muscle
Definition
lateral epicondylitis (tennis elbow)
Term
inflammation of the pronator teres-flexor carpi radialis, tenderness over the medial epicondyle worse w pulling activities, reproduced by performing wrist flexion against resistance w the elbow fully extended
Definition
medial epicondylitis (golfer's elbow)
Term
high energy fall on outstretched hand w hyperextension, posterior is most common. presents w flexed elbow, marked olecranon prominence and inability to extend the elbow, emergent reduction
Definition
elbow dislocation
Term
ulnar nerve compression at the cubital tunnel along the medial elbow leading to paresthesias/pain along the ulnar nerve. pos tinel's sign at the elbow, pos froment's sign (holds paper and compensated w flexion of IP joint)
Definition
cubital tunnel syndrome (ulnar neuropathy)
Term
fall on outstretched hand on extended wrist, pain along radial surface of wrist, snuffbox tenderness
Definition
scaphoid (navicular) fracture, mc carpal fracture, snuffbox tenderness has inc risk of avascular necrosis->treat w thumb spica
Term
pain on dorsal radial side of wrist, pos terry thomas sign
Definition
scapholunate dissociation (terry thomas sign is >3mm space)
Term
distal radius fracture w dorsal/posterior angulation, most commonly a fallon outstretched hand w wrist extension, dinner fork deformity, can get extensor pollicus longus tendon rupture, treat w sugar tong splint/cast, often postmenopausal, asian, osteoporotic women
Definition
colles fracture (dorsal angulation)
Term
ventral/anterior angulation, most commonly fall on outstretched hand w wrist flexion
Definition
smith fracture
Term
intra-articular distal radius fracture w carpal displacement
Definition
barton fracture
Term
capitate non longer articulates w lunate, lunate still articulates w radius
Definition
perilunate dislocation
Term
lunate doesn't articulate w botht he capitate or the radius, emergent consult, piece of pie sign, spilled teacup sign, unstable
Definition
lunate dislocation
Term
most serious carpal fracture, avascular necrosis leading to kienbock's disease
Definition
lunate fracture, radiographs often negative
Term
autonomic dysfunction following bone or soft tissue injuries, stage I: pain out of propertion to injury, autonomic nervous system symptoms, management w vitamin C prophylaxis after fractures
Definition
complex regional pain syndrome, formerly known as reflex sympathetic dystrophy
Term
extensor tendon avulsion after sudden blow to tip of an extended finger w forced flexion, inability to straighten the distal finger (flexed at DIP joint), splint the DIP in uniterrupted extension
Definition
mallet (baseball) finger
Term
sharp force against the tip of a partially extended digit -> hyperflexion at the pip joint w hyperextension at the DIP
Definition
boutonniere deformity
Term
finger hyperextended at PIP joint and flexed at DIP joint
Definition
swan neck deformity
Term
sprain or tear of the ulnar collateral ligament of the thumb -> instability of MCP joint. chronic hyperabduction injury (forced abduction of thumb), valgus stress (pulling thumb away from hand), may have fracture at base of proximal phalanx, management w thumb spica, refer to hand surgeon (bc affect pincer function)
Definition
gamekeeper's (skiers) thumb
Term
fracture at the neck of 5th metacarpal (+/- 4th). punching w clenched fixt, treat w ulnar gutter splint, always check for bite wounds (amoxicillin/clauvanic acid)
Definition
boxer's fracture
Term
intraarticular fracture through the base of 1st metacarpal (MCP) bone, unstable
Definition
bennet fracture
Term
comminuted bennett's fracture (two fractures through base of 1st metacarpal)
Definition
rolando fracture
Term
growth (epiphyseal plate fractures)
Definition
Salter-harris fractures
type 1: isolated growth plate fracture
type 2: growth plate fracture + fracture of the meaphysis, mc
type 3: growth plate fracture + fracture of epiphysis
type 4: fracture extending across teh metaphysis, growth plate and epiphysis, needs reduction
type 5: growth plate compression injury, may arrest growth, worst type
Term
stenosing tensynovitis of the abductor pollicus longus and extensor pollicus brevus, pain along the radial aspect of the wrist radiating to the forearm, pos finkelstein test, manage w thumb spica splint
Definition
de Quervain tensynovitis (pos finkelstein is pain w ulnar deviation or thumb extension)
Term
median nerve entrapment/compression, inc incidence w diabetes mellitis, paresthesias and pain of palmar 1st, 3& 1/4 of 4th digits esp at night, thenar muscle wasing, pos tinnel's sign, pos phalen's sign, treat w volar splint
Definition
carpal tunnel syndrome (tinnel's sign is percusison of the median nerve produces symptoms, phalen's sign is flexion of both wrists for 30-60 sec reproduces symptoms
Term
proximal forearm pain and not associated w pain at might, median nerve comprexxion
Definition
pronator syndrome
Term
nodules over the distal palmar crease or proximal phalanx esp ring, little finger, painful nodules, fixed flexion deformity at MCP joint
Definition
dupuytren contracture
Term
high impact injury like MVA, may have perineal ecchymosis
Definition
pelvic fracture
Term
trauma MC cause, complication of avascular necrosis, sciatic nerve injry, usually posterior, leg shortened and internally roatated and adducted w hip/knee slightly flexed
Definition
hip dislocation (anterior lef externally rotated)
Term
mc in osteoporotic women, can have high incidence of avascular necrosis w femoral neck fractures, hip pain w leg shortened, externally rotated, abducted
Definition
hip fracture
Term
idiopathic avascular osteonecrosis of the femoral head in children due to ischemia of capital femoral epiphysis in children, most common in children 4-10 y and 4x in boys, painless limping, loss of abduction and internal rotation, inc density of femoral head and widening of cartilage space, crescent sign, management observation and restriction with orthopedic follow up
Definition
legg-calve-perthes disease
Term
femoral head (epiphysis) slips posterior and inferior at the growth plate, MC in 7-16y obese African-American males during growth spurt, if seen in children before puberty, suspect hormonal/systemic disorders like hypothyroidism. hip, thigh or knee pain w limp, external rotation of affected leg, ORIF
Definition
slipped capital femoral epiphysis
Term
incomplete fracture w cortical disruption & periosteal tearning on the convex side of the fracture, bowing, in pediatrics
Definition
geenstick fractures
Term
incomplete fracture w wrinklink or bump of metaphyseal-diaphyseal junction due to axial loading, in pediatrics
Definition
torus (buckle) fracture
Term
vaLgus stress w rotation
Definition
MCL injury
Term
vaRus stress
Definition
LCL injury
Term
Grades 1 (sprains) and 2 (incomplete tears) vs grades III (complete tears), localized pain swelling ecchymosis, stiffness
Definition
conservative vs surgical repair, MCL and LCL knee injuries
Term
MC knee ligament injury, 70% sports-related, noncontact pivoting injury (deceleration, hyperextension, internal rotation), pop&swelling->hemarthrosis, knee buckling, inability to bear weight, MC in women, Lachman's test and anterior drawer test, +/- Segond fracture
Definition
ACL injury. lachman's: most sensitive, pivot shift test. anterior drawer test least reliable bc spasms may stabilize knee. segond fracture: avulsion of the lateral tibial condyle w varus stress to the knee, if present, ligamental injuries are most likely present, pathognomonic for ACL tear
Term
unhappy O'Donoghue's traid
Definition
injry to ACL + CL + Medical meniscus
Term
MC associated w dashboard injuries (anterior force to proximal tibia w knees flexed), anterior bruising, large effusion. pivot shift test, posterior drawer test
Definition
PCL injuries
Term
degenerative due to squatting, twisting, compression or trauma w femur rotation of the tibia, pos McMurray's sign, locking, popping, giving way, effusion after activities, also apley test, joint line tenderness, effusion
Definition
meniscal tears (medial 3x MC>lateral), McMurray's sign is a pop or click while tibia is externally and internally rotated
Term
mc direct blow- fall on a flexed knee +/- forceful quadriceps contraction, MC in young patients, sunrise view radiographs, limited knee extension w pain, mc in young pts
Definition
patellar fracture
Term
forceful quadriceps contraction (fall on a flexed knee, walking up/down stairs), MC in males >40y, history of systemic disease, inability to extend knee/straight leg raise
Definition
patellar and quadriceps tendon ruptures
quadriceps tendon rupture: patella baja- palpable defect above knee
patellar tendon rupture: patella alta- palpable defect below knee
Term
valgus stress after twisting injury, direct blow. MC in females, usually laterally, pos apprehension sign
Definition
patellar dislocation, apprehension sign: pt exhibits anxiety/forcefully contracts the quadriceps when the examiner pushes laterally. only performed if patellar is already reduced
Term
severe limb threatening emergency, high velocity trauma, popliteal aprery injury in 1/3 of pts->arteriography +/- peroneal or tibial nerve injury, immediate orthopedic consult
Definition
Knee (tibial-femoral) dislocations
Term
axial loading (fall from height), direct blow, peroneal nerve insuries (check 1st web space), popliteal artery injury, immediate orthopedic consult
Definition
femoral condyle fractures
Term
axial loading/rotation/direct trauma, MC in children in MVA, lateral MC, check for peroneal nerve injury (foot drop), +/- hard to see on radiographs, may need to confirm w CT/MRI
Definition
tibial plateau fractures
Term
osteochondritis of the patellar tendon at tibial tuberosity from overuse, MC cause of chronic knee pain in young, active adolescents, MC males 10-15y, athletes w growth spurts, activity- related (running, jumping), tenderness to anterior tibial tubercle, rice, NSAIDS, quadriceps strewtching
Definition
Osgood-Schlatter disease
Term
synovial fluid effusion is displaced with cyst formation, ruptured cyst-> pseudothrombophlebitis syndrome that mimics DVT, ultrasound for diagnosis
Definition
Baker's cyst
Term
idiopathic softening/fissuring of the patellar articular catilage, MC in runners, anterior knee pain behind or around the patella worsened w knee hyperflexion (prolonged sitting), pos apprehension sign, NSAIDS reset and rehad
Definition
patellofemoral syndrome (chondromalacia), apprehension sign is examiner applies pressure medial - lateral patella w pain or pt refuses test in anticipation of pain
Term
MC cause of knee pain in runners, lateral knee pain during onset then resolves, worse w climbing stairs or running downhill, pos ober test- pain or resistance to adduction of the leg parallel to the table in neutral position, pos lateral condyle tenderness
Definition
iliotibial band (ITB) syndrome
Term
major trauma, posterior MC +/- peroneal nerve injury, inabitlity to bear weight, treat w closed reduction and posterior splint
Definition
ankle dislocation
Term
85% incolve the collateral ligaments (anterior talofibular-inversion MC, calcaneofibular), deltoid ligament w eversion injuries, pop, RICE, NSAIDS
Definition
ankle sprains
Term
ottawa ankle rules
Definition
ankle films- pain along lateral malleolus, pain along medial malleolus
foot films- navicular (midfoot) pain, 5th metatarsal pain
both- inability to walk >4 steps at time of injury and in ER
Term
mechanical overload from eccentric contraction of gastrocsoleus complex, 75% sports-related, 30-50, inc risk w fluoroquinolone use, sudden heel pain after push-off mvmnt, pop, sudden sharp calf apin, pos thompson test
Definition
achilles tendon rupture. pos thompson test: weak, absent plantar flexion when gastrocnemius is squeezed
Term
Weber ankle fracture classification
Definition
Weber A- fibular fx below syndesmosis, usually table
Weber B- fibular fx at level of syndesmosis
Weber C- fibular fx above mortise
Term
spiral proximal fibular fracture as a result of distal medial malleolar fracture and/or deltoid ligament rupture
Definition
maisonneuve fracture (anyone w distal ankle fracture should have a proximal view to r/o Maisonneuve)
Term
fracture of the distal tibia from impact with the talus (axial load), extends into the ankle joint
Definition
pilon (tibial plafond) fracture
Term
common in athletes and miliatry personnel due to overuse, 3rd metatarsal MC, 50% of xrays will be neg, pos w healing
Definition
stress (march) fracture
Term
heel pain, tenderness of the plantar fascia of the medial foot, may inc w dorsiflexion of toes, pain usually worse after period of resk ex 1st few steps in the morning, esp in pts w flat feet or heel spur
Definition
plantar fasciitis
Term
posterior tibial nerve compression from overuse, pain/numbness at the medial malleolus heel & sole, pain worsens at night and with dorsiflexion, pos tinel sign, can mimic plantar fasciitis but this in this pain ic's throughout the day
Definition
Tarsal Tunnel syndrome
Term
hallux valgus deformity of the bursa over 1st metatarsal, hx of wearing poorly fitted shoes mc, 1st metatarsal lateral deviasion
Definition
bunion (hallux valgus)
Term
flexion of PIP joint & hyperextension of MTP & MIP joint, PIP pain due to contact w shoe, PIP deformity
Definition
hammer toe
Term
joint damage & destruction as a result of peripheral neuropathy from DM peripheral vascular disease or other diseases, MC affects midfoot, obliteration of joint space
Definition
charcot's joint (diabetic foot)
Term
degeneration/proliferation of plantar digital nerve, painful mass near the tarsal heads, MC in women 25-50y esp w tight shoes/high heels/flat feet, lancinating pain esp w ambulation, 3rd metatarsal head MC, surgical resection can cause permanent numbness
Definition
Morton's neuroma
Term
transverse fracture through the diaphysis of the 5th metatarsal, often complicated by nonunion/malunion
Definition
Jones Fracture
Term
transverse avulsion fracxture at base (tuberosity) of 5th metatarsal due to plantar flexion w inversion, management is wlking cast
Definition
pseudojones fracxture
Term
disruption between the articulation of the medial cuneiform and the base of the 2nd metatarsal, fleck sign- fracture at the base of the 2nd metatarsal is pathognomonic, widening between 1st and 2nd joint space
Definition
lisfranc injury
Term
pain in a dermatomal pattern, MC at L5-S1 (bc juntion between mobile and non-mobile spine), sciatica- back pain radiating to the thigh/buttock-> lower leg down L5-S1 dermatome inc w valsalva, pos straight leg raise, maybe pos crossover test
Definition
herniated disc (nucleus pulposus). L4- anterior tight pain, weak ankle dorsiflexion, loss of knee jerk. L5- lateral thigh/leg hip and grain pain+dorsum of foot, weak big toe extension walking on heels more difficult than on toes, normal reflexes usuially. S1- posterior leg/calf pain, + plantar surface of the foot, weak plantar flexion, loss of ankle jerk
Term
new onset of urinary or bowel retention/incontinence w sadddle anesthesia, uni/bilateral leg radiation, dec anal sphincter tone on rectal exam, no anal wink, neurosurgical emergency treat w corticosteroids to reduce inflammation, serious complication of herniated lumbar disc syndrome
Definition
cauda equina syndrome
Term
narrowing of the spinal canal w impingement of the nerve roots seen >60y, back pain that worsens w extension + prolonged standing/walking, releived w flexion- sitting/walking uphill, manage w lumbar epidural injection of corticosteroids
Definition
spinal stenosis (pseudoclaudication, neurogenic)
Term
acute strain or tear of paraspinal muscles esp after twisting/lifting injuries, bavck muscle spasms, no neurologic changes
Definition
lumbosacral sprain/strain
Term
burst fractures in children from jumping/fall from height, lumbar compression fractures in elderly, pathologic fractures in malignancy, pain and point tenderness at the level of compression
Definition
spinal compression fractures
Term
lateral curvature of spine >10 deg, can be associated w kyphosis or lordosis, diagnosis w adams forward bending test (most sensitive), cobb's angle measured on AP/lateral films
Definition
scoliosis
Term
pars interarticularis defect from either failure of fusion or stress fracture, often from repetitive hyperextension trauma (football players, gymnasts) MC form of back pain in children and adolescents MC at L5/S1
Definition
spondylolysis
Term
forward slipping of a vertebrae on another MC 10-15y (adolescence), may cause bowel or bladder dysfunction
Definition
spondylolisthesis
Term
inflammation/infecxtion of bone by pyogenic organisms MC<20y&>50y, acute hematogenous spread MC in children or direct innoculation or contiguous spread w vascular insufficiency, local signs: inflammation/infection, pain over the involved bone. inc WBC, inc ESR. MRI most sensitive in early disease. early radiographys show soft issue swelling & periosteal reaction (lucent areas of corticodestruction), advanced/chronic radiographs show sequestrum, radionuclide bone or gallium scan is sensitive in early diseaes, blood cultures pos in 50%, bone aspiration is gold standard. treat w surgical debridement and cultures and antibiotics
Definition
osteomyelitis
Term
MC seen in children, S.aureus MC organism, salmonells pathognominic for sickle cell disease, S. pyogenes
Definition
acute osteomyelitis
Term
MC in adults 2ndary to injury/bone surrounding soft tissue, S.aureus MC organism, coag neg staph in prosthetic joint infections, gram neg: pseudomonas IVDU, serratia, E.coli
Definition
chronic (subacute) osteomyelitis
Term
treatment for group b strep, gram neg (newborn)
Definition
osteomyelitis, nafcillin or oxacillin + 3rd gen cephalosporin
Term
treatment for s.aureus
Definition
nafcillin/oxacillin or Cefazolin (clindamycin or vanco if PCN allergic) MRSA- vanco or linezolid
Term
treatment for Salmonella + s.aureus (sickle cell osteomyelitis)
Definition
3rd gen cephalosporin or RQ (cipro or fevofloxacin)
Term
treatment for psudomonas
Definition
(puncture wound). ciprofloxacin or levofloxacin, ceftazidime or cefepime
Term
medicxal emergency bc it can rapidly destroy the joint. most monomicrobial. spread hematogenous, direct innoculation or contiguous (ex from osteoarthritis or after other infection), s. aureus mc organism, N. gonorrheae in sexually active young adults- ass w tensosynovitis, Strep, gram neg, staph epi if prosthesis, mycobacteria and fungi less common, neonates- Group B strep, s. aureus, H. flu. Joint involvement- single, swollen, warm, apinful joint, dec ROM, tender to palpation, knee MC, fever. diagnose w arthrocentesis, WBC >50,000- primarily PMNS- gram stain and culture, crystals (WBC >1,100 considered pos in prosthetic joints). prompt antibiotics guided by gram stain
Definition
septic arthritis
Term
septic arthritis NOS treatment
Definition
nafcillin or vancy + ceftriaxone (+- anti-Pseudomonas)
Term
septic arthritis gnc orgonococcus suspected
Definition
ceftriaxone
Term
septic arthritis gnr
Definition
ceftriaxone (3rd gen cephalosporin) + anti-pseudomonal aminoglycoside (ex Gentamicin)
Term
muscle/nerve ischemia, dec tissue perfusion when closed muscle compartment pressure ? perfusion pressure. etiologies trauma, MC after fracture of long bones. pain out of proportion to injury, volkmann's contracture, pain on passive stretching is earliest indicator, tense extremities, inc intracomparmental pressure >30-45 mmHg, management w fasciotomy
Definition
compartment syndrome
Term
MC bone malignancy, MC in adolescents, produces osteoid (immature bone), 2nd peak 50-60y, MC METS to the lungs, bone pain/joint swelling, radiographs show hair on end or sun ray/burst appearance of the soft tissue mass and codman's triangle, chemotherapy as adjuvant treatment
Definition
osteosarcoma
Term
giant cell tumor MC in children, MC in males 5-25y, femus MC and pelvis, layered periosteal reaction/onion skin appearanceon readiographs, may see codman's triangle
Definition
ewing sarcoma
Term
cancer of the cartilage, MC seen in adults 40-75 y, diagnosis by punctate or ring&arc appearance of calcification, management w surgical resection
Definition
chondrosarcoma
Term
MC benign bone tumor esp ages 10-20y, MC in males, may precede chondrosarcomas, often pedunculated, grows away from growth plate and involved medullary tissue
Definition
osteochondroma
Term
abnormal bone remodeling & disorganized osteoid formaiton, MC >40y (elderly), mainly persons of western European descent, disordered bone remodeling w inc osteoclast bone resorption, inc abnormal trabecular bone formation -> larger, weaker, less compact bones + prone to fractures, lytic phase w inc osteaclast activity -> mixed phase -> sclerotic phase w inc osteoblast activity. MC asymptomatic and found w high alkaline phosphatase or on radiogrphs, MC symptoms is bone pain w inc warmth, skull involvement can lead to deafness (headach). on gradiograph see blade of grass/flame shaped lucency in lytic phase, corasened trabeculase in sclerotic phase, skull = cotton wool appearance. treat w bisphosphonates (PO: Alendronate, Risedronate, IV Zoledronic acid, Pamidronate) to inhibit osteoclas activity, calcitonin can dec osteoclast activity
Definition
paget disease of the bone (osteitis deformans)
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