BONE SOFTENING DISEASES BONE TISSUE CELLS BONE FORMING

BONE SOFTENING DISEASES

BONE TISSUE • CELLS - BONE FORMING (OSTEOBLAST) - BONE RESORPTION (OSTEOCLASTS) • MATRIX -OSTEOID . COLLAGEN. BLOOD VESSELS - MINERALS CALCIUM PHOSPHATE HYDROXYAPATITE CRYSTALS BONE REMODLING CYCLE Resorption + Formation

DISTURBED OSTEOID FORMATION OSTEOGENESIS IMPERFECTA DISTURBED MINERALIZATION RICKETS, OSTEOMALACIA DISTURBED REMODELING CYCLE OSTEOPOROSIS, HYPERPARA-

OSTEOGENESIS IMPERFECTA: CONGENITAL INFANTILE TARDA Defective osteoid Fragile bone Defect in collagen ligament laxity blue sclera

OSTEOGENESIS IMPERFECTA: CONGENITAL INFANTILE TARDA Defective osteoid Fragile bone Defect in collagen ligament laxity blue sclera

RICKETS CAUSES: INFANTILE COELIAC RENAL ACTIVE HEALING HEALED CLINICAL PICTURE Deformities Rickety rosary Harrison sulcus Marfan sign Broad metaphyses

Genu varum & valgum

RICKETS MANAGEMENT INFANTILE COELIAC RENAL + CORRECTION OF DEFORMITY

HYPERPARATHYROIDISM BONE RESORPTION • HYPERCALCAEMIA • RECURRENT RENAL CALCULI • BONY CHANGES: - CYSTIC CHANGES - BONE DEFORMITIES - PATHOLOGICAL FRACTURES

CAUSES RISK FACTORS

Risk factors requesting diagnosis with bone densitometry: l Oestrogen deficiency Premature menopause (< 45 years) Prolonged secondary amenorrhoea (> 1 year) l Loss of height, thoracic kyphosis Prolonged corticosteroid therapy l Maternal family history of hip fracture l Low body mass index (< 19 kg/ m 2) l Other osteoporosis- related disorders: l Anorexia nervosa Prolonged immobilization Malabsorption Primary hyperparathyroidism European Foundation for Osteoporosis and Bone Disease

PATHOLOGY

LOSS OF HORIZONTAL TABECULAE HYPERTROPHY OF VERTICAL TRABECULAE

CLINICAL PICTURE

FEMORAL NECK & TROCHANTERIC FRS.

COLLES FRACTURE

VERTEBRAL FRACTURE

PLAIN X- RAY SPINE HIP WRIST

SPINE HIP ARM DENSITOMETRY

LAP TESTS BONE MARKERS FORMATION RESORPTION CA, P, A. P

MANAGEMENT PREVENTION

MANAGEMENT HRT SERM CACITONIN ANTIRESORPTIVE PARATHORMONE + TREAT COMPLICATIONS