The Skeletal System Part 4 Skeletal System Problems

The Skeletal System Part 4: Skeletal System Problems

Common Types of Fractures Type of Site Description Linear Parallel to long surface of bone Transverse Perpendicular to long surface of bone Oblique Diagonal fracture across bone Comminuted bone fragments into 3+ pieces; common in the elderly Spiral ragged break when bone is excessively twisted; common in sports Avulsion pieces of the bone have been pulled apart Impacted opposite of avulsion – piece of bone pushed into another piece of bone Fixture cracks in the bone Depressed broken bone portion pressed inward; typical skull fracture Greenstick Incomplete: one side of the bone breaks and other bends; in children Compression bone is crushed; common in porous bones Epiphyseal epiphysis separates from diaphysis along epiphyseal line

Common Types of Fractures

Top 5 Broken Bones Type of Site 1. Clavicle 2. Arm Description Usually broken in falls Radius, ulna, or humerus 3. Wrist absorbs much force when we instinctively place our hands out to break our fall 4. Hip Most common bone in people over 65; women have highest risk due to calcium loss after menopause (osteoporosis) 5. Ankle Twisting ankles too far can cause a break

Other Skeletal Injuries Sprains Dislocations • When the ligaments • When bones in a that reinforce a joint are forced out are stretched or of alignment torn • Partially torn ligaments repair themselves slowly • Completely torn ligament need surgical repair Cartilage Injuries • When the cartilage at joints become overstressed • Caused by big falls and sports injuries • Cartilage can snap, break, or be worn down • Usually includes sprains, inflammation, and loss of joint mobiity • Usually repaired by arthroscopic surgery (a small incision + camera)

Other Skeletal Injuries Sprains Dislocations Cartilage Injuries

Common Skeletal Disorders Disorder Description Spinal Stenosis Narrowing of the spinal column Achondroplasia Dwarfism, defect in cartilage at growth plates of long bones A chronic inflammatory diseases involving joints in children Juvenile Rheumatoid Arthritis under 16 Ankylosing Spondylitis Immobility of a joint in the spine Osteosarcoma Bone cancer; bone matrix not as strong as normal Osteoporosis Creation of new bone doesn’t match loss of old bone; bones become weak and brittle; susceptibility to fractures Herniated Disc When the soft center of a spinal disk between 2 vertebrae pushes through a crack into the spinal canal Scoliosis Lateral curve of the spine

• Inflammation of the fluid-filled pads (bursae) that act as cushions at joints • • Usually caused by a blow or constant friction Bursitis occurs most often at joints that perform frequent, repetitive motion Common areas are the knees, shoulders, elbows, and hips • Symptoms: • Pain, swelling, stiffness Course: • Treated with rest, ice, pain relievers, antiinflammatory drugs (ibuprofen), excessive fluid may be aspirated • Surgery is rarely needed

Different Types: 1. Osteoarthritis (OA) 2. Rheumatoid arthritis (RA) 3. Juvenile rheumatoid arthritis (JRA) 4. Gouty arthritis (GA)

• Type of arthritis that occurs when flexible tissue (cartilage) at the end of bones wears down. • Most common arthritis; 85% of all Americans develop OA; affects women more than men Known as “wear and tear” arthritis; more prevalent in the aged, due to normal aging • Symptoms: • severe pain, redness and tenderness in joints Course: • OA reflects years of abrasion (rubbing) and compression which increases production of metalloproteinase enzymes that break down cartilage • The exposed bone ends thicken, enlarge, form bone spurs, and restrict movement • Most affects cervical and lumbar spine, fingers, knuckles, knees and hips

Treatment: • OA is slow and reversible • Treatment includes mild pain relievers (Aleve) and moderate physical activity • Magnetic therapy • Glucosamine sulfate to reduce pain and inflammation • SAM-e (s-adenosylmethionine) builds up cartilage matrix and regenerates tissue

• • Chronic, inflammatory, autoimmune disease of unknown cause with insidious (stealthy) onset Usually arises between 40 – 50, but an occur at any age Symptoms: • joint tenderness, anemia, osteoporosis, muscle atrophy (shrinkage), cardiovascular problems Course: 1. RA begins with synovitus of affected joint 2. Inflammatory blood vessels migrate to joint, causing swelling 3. Inflamed synovial membrane thickens into a pannus 4. Pannus erodes cartilage; scar tissue forms, bone ends fuse 5. Ends with ankylosis: stiffening and immobility of joint due to bone fusion; bent fingers

Treatment: • Conservative therapy: aspirin, long-term use of antiobiotics, and physical therapy • Progressive therapy: anti-inflammatory drugs (NSAIDs) or immuno suppressants • The drug Embrel, removes cells that promote inflammation

• A form of arthritis characterized by severe pain, redness and tenderness in joints • Due to deposition of uric acid crystals in joints and soft tissues, followed by an inflammation response Usually, affects the joint at base of big toe • Symptoms: • severe pain, redness and tenderness in joints Course: • If untreated, gouty arthritis can cause the bone ends to fuse and immobilize the joint Treatment: • Colchicine, NSAID drugs, glucocorticoids

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