Term
| Cells involved in bone formation and remodeling |
|
Definition
| osteoblasts, osteoclasts, and osteocytes |
|
|
Term
|
Definition
| osteoid forming cells. Have receptors for parathyroid hormone. Contain alkaline phosphatase. |
|
|
Term
|
Definition
| osteoblasts trapped in lacunae following mineralization of osteoid. Maintain matrix of bone. |
|
|
Term
|
Definition
| multinucleated cells actively involved in resorption of mineralized bone. Contain acid phosphatase. |
|
|
Term
| Main Portions of the long bone |
|
Definition
| diaphysis, epiphysis and metaphysis |
|
|
Term
|
Definition
| the shaft of a long bone. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| the growth zone between the epiphysis and diaphysis. |
|
|
Term
|
Definition
forms the dense walls of the shaft of long bones. Composed of parallel columns made up of concentric bony layers (lamellae) arranged around channels containing blood vessels, lymphatics and nerves.
The channels run parallel to the long axis of the bone |
|
|
Term
|
Definition
occupies the large central medullary cavity of long bones. Composed of a network of
bony trabeculae separated by a labyrinth of interconnecting spaces containing bone marrow |
|
|
Term
|
Definition
| membrane covering the outer surfaces of bone |
|
|
Term
|
Definition
| membrane lining the inside of bone |
|
|
Term
| Rickets (in growing child) and Osteomalacia (in adults) |
|
Definition
| skeletal disorders caused by vitamin D deficiency |
|
|
Term
|
Definition
| childhood skeletal disorder caused by vitamin D deficiency |
|
|
Term
|
Definition
| inadequate vitamin D causes inadequate mineralization of bone at growth plate and hypocalcemia which leads to increased PTH. Increased PTH (1) activates renal alpha1-hydroxylase (2) mobilizes calcium from bone (3) decreases calcium excretion and (4) increased renal excretion of phosphate to return serum calcium levels back to normal |
|
|
Term
| Clinical course of Rickets |
|
Definition
| skeletal defomatities in growing bones, especially bow legs and knock knees and pigeon breast deformaity |
|
|
Term
| Defintion of osteomalacia |
|
Definition
| adult skeletal disorder caused by vitamin D deficiency |
|
|
Term
| Pathogensis of osteomalacia |
|
Definition
| inadequate vitamin D causes inadequate mineralization of bone at growth plate and hypocalcemia which leads to increased PTH. Increased PTH (1) activates renal alpha1-hydroxylase (2) mobilizes calcium from bone (3) decreases calcium excretion and (4) increased renal excretion of phosphate to return serum calcium levels back to normal |
|
|
Term
| Clinical course of osteomalacia |
|
Definition
| inadequate mineralization of bone matrix, ALK elevated and phosphorus decreased but serum calcium is normal |
|
|
Term
|
Definition
|
|
Term
|
Definition
usually caused by bacteria which reach bone through the bloodstream, by extension of contiguous
infection, or by direct traumatic introduction. |
|
|
Term
| Tuberculous osteomyelitis |
|
Definition
seen in debilitated patients, represents hematogenous spread from another primary
source, usually the lung. Is destructive and difficult to control. Commonly affects the long bones of the extremities and spine (Pott disease). |
|
|
Term
| Common causes of osteomyelitis |
|
Definition
| can be pyogenic or tuberculoid, pyogenic due to bacteria most commonly S. aureus (acute osteomyelitis can lead to chronic) or tuberculoid due to mycobacterium |
|
|
Term
| Method of bone infection of osteomyelitis |
|
Definition
| in pyogenic bacteria reach the bone by blood, direct extension or traumatic implantatiom in tuberculoid mycobacteria reached bone and is spread by blood (Potts disese) |
|
|
Term
| Clinical course of osteomyelitis |
|
Definition
| Pyogenic osteomyelitis starts as acute in which bone becomes necrotic and the infection spreads to the cortical bone and can cause an abscess and infect joints, chronic osteomyelitis is characterized by osteoclast activation, fibrosis and new bone formation and sequestrum (residual necrotic bone) and involucrum (reactive bone). Myobacterial osteomyelitis involved long bones and vertebrae |
|
|
Term
| Definition of osteoarthritis |
|
Definition
| degeneration of articular cartiledge related to aging, mechanical trauma or loss of blood supply |
|
|
Term
| Morphologic features of osteoarthritis |
|
Definition
| loss of articular cartilage with bone remodeling, fibrillation, fissures from cariledge to bone, erosion of cartildge exposing bone which beomces eburnated, and joint mice |
|
|
Term
| Pathogenesis of osteoarthritis |
|
Definition
| degenerating cartiledge contains more water which causes increased break down of collagen II, leads to spltting of ariticular surface and exposed bone which can break off |
|
|
Term
| Clinical course of osteoarthritis |
|
Definition
| more common in weight bearing joints and increased frequency with obesity and joint deformatity leads to pain from bone grinding on bone and joint mice |
|
|
Term
| Definition of Rheumatoid arthritis |
|
Definition
| a multisystem, chronic, relapsing, inflammatory disease of unknown cause |
|
|
Term
| Morphologic features of Rheumatoid arthritis |
|
Definition
| symmetric involvement, swam neck deformity, subcutaneous nodules of granulation tissue that contain central fibrinoid necrosis with palisaded macrophages and granulation tissue, synovial cell hyperplasia and capsule formation |
|
|
Term
| Etiology of Rheumatoid arthritis |
|
Definition
| autoimmune (?), genetic predisposition, Rheumatoid factor in serum and joint fluid |
|
|
Term
| Pathogenesis of Rheumatoid arthritis |
|
Definition
| RF and IgM antibodies against Fc portion of IgG, synovial cell hyperplasia with dense plasma cell infiltrate causes increased vascularity and pannus, leads to fibrosis and anklyosis |
|
|
Term
| Clinical course of Rheumatoid arthritis |
|
Definition
| severe form of chronic synovitis that can lead to destruction and anklysis of joints, can affect skin, eyes, heart, lung, and other organs |
|
|
Term
| Gout (Uric Acid Arthritis) |
|
Definition
due to deposition of uric acid crystals in soft tissues of and around joints, of foot, ankle and
knee. Many patients have elevated levels of serum UA, but individuals with increased levels do not necessarily
develop gout. Crystals induce a substantial inflammatory reaction. Diagnosis made by removal of inflamed joint fluid and examining for crystals. |
|
|
Term
| Definition of osteoporosis |
|
Definition
| reduction in bone mass suffient to make skelton fragile and vulternable to fracture |
|
|
Term
| Incidence of osteoporosis |
|
Definition
| common (15 million) in elderly people, mostly women after menopause |
|
|
Term
| Pathogenesis of osteoporosis |
|
Definition
| related to genetics, reduced physical activity, calcium levels and estrogen deficiency (women) or androgen deficiency (men) |
|
|
Term
| Clinical course of osteoporosis |
|
Definition
| reduction in bone mass characterized by fewer, thinner boney spiculae with the greatest loss in cancellous (trabecular) bone. Normal bone density declines at a rate of 0.7% per year, when rate of bone resorption exceeds formation = osteoporosis |
|
|
Term
| Definition of Paget’s disease |
|
Definition
| metabolic disease of bone characterized by localized osteoclastic activity with resorption and exuberant bone formation |
|
|
Term
| Incidence of Paget’s disease |
|
Definition
| common in people over 40, slightly more common in males |
|
|
Term
| Radiologic changes of Paget’s disease |
|
Definition
| thickened bone but unstable, incidental finding |
|
|
Term
| Clinical course of Paget’s disease |
|
Definition
| osteolytic to osteolytic/osteoblastic to osteosclerotic and 1% can develop osteosarcoma, mutlifocal lesions seen in many different bones |
|
|
Term
| Paget’s disease of the bone |
|
Definition
| episodic osteoclastic bone resorption followed by osteoscelortic bone formation, results in multifocal bone lesions with 1% developing to osteosarcoma |
|
|
Term
| Paget’s disease of the breast |
|
Definition
| red scaling rash involving nipple with coorelates with a high risk of intraducal carcinoma |
|
|
Term
| Paget’s disease of the vulva |
|
Definition
| red, crusting, itching lesion associated with adenocarcinoma seen in postmenopausal women |
|
|
Term
| Enchondroma, osteochondroma |
|
Definition
may show formation of bone, cartilage or both. Typical presentation is a bony
defect with or without pain. Removal of tumor, if defect is reparable, is curative |
|
|
Term
| Incidence of giant cell tumors of bone |
|
Definition
|
|
Term
| Common anatomic sites of origin of giant cell tumors of bone |
|
Definition
| epiphyses of long bones, distal femur, proximal tibia, proximal humerus, distal radius |
|
|
Term
| Gross features of giant cell tumors of bone |
|
Definition
| dark brown and hemorrhagis, areas of necrosis and cystic change |
|
|
Term
| Biologic potential of giant cell tumors of bone |
|
Definition
| most tumors are benign, most recur but sarcomatous transformation israre, mononuclear cells are neoplastic and multinucleated giant cells represent a reactive cell component |
|
|
Term
| Clincal course of giant cell tumors of bone |
|
Definition
| treatment with curettage or conservation but recurrences are frequent and can occur 20-30 years post resection, 1% mets to lungs |
|
|
Term
| Definition of osteosarcoma |
|
Definition
| malignant tumor arising from osteoid or bone |
|
|
Term
| Incidence of osteosarcoma |
|
Definition
| primary is mot common malignant bone tumor, people under the age of 20, more common in males for primary, older people for secondary |
|
|
Term
| Common anatomic sites of origin of osteosarcoma |
|
Definition
| primary seen in long bones before epiphyses have closed, most commonly around knee, for secondary in site of preexisting bone pathology |
|
|
Term
| Gross features of osteosarcoma |
|
Definition
| enlarging painful knee mass |
|
|
Term
| Clinical course of osteosarcoma |
|
Definition
| progressively enlarging painful mass around knees, aggressive with mets to lungs in 20% of presentations |
|
|
Term
| Incidence of Chrondosarcoma |
|
Definition
| 60’s and male, second most common primary bone tumor |
|
|
Term
| Common anatomic sites of origin of Chrondrosarcoma |
|
Definition
| ribs, shoulders, pelvic bones, around the knee |
|
|
Term
| Gross features of Chrondrosarcoma |
|
Definition
| can be well to poorly differentiated |
|
|
Term
| Clinical course of Chrondrosarcoma |
|
Definition
| indolent- causing little or no pain |
|
|
Term
| Incidence of Ewing Sarcoma |
|
Definition
| 20’s males, second most common bone tumor in children |
|
|
Term
| Morphology of Ewing Sarcoma |
|
Definition
| involves medullary cavity with expansion of bone, small round, blue cells, glycogen rich (PAS positive) and positive for neural markers (CD99/MIC 2) |
|
|
Term
| Radiologic appearance of Ewing Sarcoma |
|
Definition
| destructive lytic tumor with infiltrative margins and extension into surrounding soft tissue |
|
|
Term
| Clincal course of Ewing Sarcoma |
|
Definition
| pain and fever, 75% 5 year survivial with treatment |
|
|
Term
|
Definition
malignant tumor of bone marrow B cells, specifically showing plasma cell differentiation (CD
138+); tumor usually develops as a mass of plasma cells with underlying destruction of bone. Mean age of
development is 65 years; 14600 new cases expected in 2002 with 10800 deaths. More than 95% of cases show
monoclonal immunoglobulin and may shed in urine as Bence-Jones proteins, IgG kappa |
|
|
Term
| Significance of Metastatic tumors |
|
Definition
| most common tumors to involve bone, produce lytic and blastic bone lesions (blastic bone lesions = mets from prostate) |
|
|
Term
| Common tumors that metastasize to bone |
|
Definition
| breast, prostate, lung, kidney and thyroid |
|
|
Term
|
Definition
|
|
Term
| Which condition commonly effects elderly males and females and is characterized by reduction in bone mass? |
|
Definition
|
|
Term
| Which of the following is an undifferentiated tumor of small round cells that arises in the medullary cavity of bone in children? |
|
Definition
|
|
Term
| An 80-year-old woman has had no major medical problems, but she has never been physically active for most of her life. One day she falls out of bed and immediately notes a sharp pain in her left hip. She is subsequently unable to walk without severe pain. Radiographs show not only a fracture of the left femoral head, but also a compressed fracture of T10. Which of the following conditions is she most likely to have? |
|
Definition
|
|
Term
| A 13-year-old boy complained of pain persisting in his left leg for 3 weeks. On physical examination his temperature was 37.9 C. A radiograph of the leg showed a mass in the diaphyseal region of the left femur with overlying cortical erosion and soft tissue extension. A bone biopsy was performed and the lesion on microscopic examination showed numerous small round blue cells. Which of the following neoplasms is he most likely to have? |
|
Definition
|
|
Term
| A 16-year-old boy noted pain in his left knee after each ice hockey practice session for one month. On examination there was tenderness to palpation of his left knee, with reduced range of motion. A radiograph of the left leg showed a mass of the proximal tibial metaphysis that was eroding the bone cortex, lifting up the periosteum where reactive new bone was apparent. The mass did not extend into the epiphyseal region. A bone biopsy was performed and microscopic examination showed atypical, elongated cells with hyperchromatic nuclei in an osteoid stroma. Which of the following neoplasms is he most likely to have? |
|
Definition
|
|
Term
| An epidemiologic study about tumor prevalence by age was performed with data entered into the hospital tumor registry for subjects who were diagnosed with bone tumors. Which of the following primary neoplasms of bone is most likely to be present in an older adult, rather than in a child or young adult? |
|
Definition
|
|
Term
| Pathogensis of osteosarcoma |
|
Definition
| primary arises de novo, secondary arrises with paget’s disease of radiation |
|
|
