Metabolic Bone Disease Flashcards
What is the pathology of Pagets disease of the bone?
- localised disorder of bone turnover
- inc. bone resoption and inc. bone formation
- disorganised bone;
- bigger + less compact
- more vascular
- more susceptible to deformity and fracture
What is the aetiology of Pagets disease of the bone?
- genetics
- poss. chronic viral infection in osteoclasts
What are the symptoms of Pagets disease of the bone?
- > 40 yrs bone pain
- bone deformity/fracture
- heat
- neurological complications (e.g. nerve deafness)
What are the investigations for Pagets disease of the bone?
- serum alkaline phosphatase (isolated inc.)
What is the treatment for Pagets disease of the bone?
- IV biphosphonate therapy
- (one-off) IV zoledronic acid
* treat only if symptomatic or in skull/area requiring surgery
What is rickets and osteomalacia?
- severe, vitamin D or calcium deficiency
- causes insufficient mineralisation
- muscle function also impaired
* rickets if child, osteomalacia if adult (epiphyseal lines closed)
What is osteogenesis imperfecta?
- genetic disorder of connective bone tissue
- fragile bones
- defects in type 1 collagen
What are the most commen types of osteogenesis imperfecta?
- type I- milder form, when child starts to walk, can present in adults also
- type II- lethal by age 1
- type III- progressive deforming, severe bone dysplasia + poor growth
- type IV- imilar to type I, but more severe
What are the signs of osteogenesis imperfecta?
- growth deficiency
- defective tooth formation
- hearing loss
- blue sclera
- scoliosis
- barrel chest
- ligamentous laxity
- easy bruising
What is the management of osteogenesis imperfecta?
- IV biphosphonates (prevent fractures)
- sugery (treat fractures)
- educational and social adaptations
- genetic counselling
What is osteoporosis?
- low bone mass + micro architectural deterioration of bone tissue
- enhanced bone fragility + inc. fracture risk
What are endocrine causes of osteoporosis?
- hyperthyroidism
- hyper/hypoparathyroidism
- Cushing’s
- hyperprolactinaemia
- hypopitutarism
- early menopause
What are rhuematic causes of osteoporosis?
- rheumatoid arthritis
- ankylosing spondylitis
- polymyalgia rheumatica
What are GI causes of osteoporosis?
- IBD
- liver diseases
- malabsorption
What are iatrogenic causes of osteoporosis?
- steroids
- proton pump inhibitors
- enzyme inducting antiepileptics,
- aromatase inhibitors
- GnRH inhibitors
- warfarin
