Bone Disorders Flashcards
(19 cards)
What are the main bone disorders
Osteomalacia
Osteopenia
Osteoporosis
Primary hyperparathyroidism
Rickets
Paget disease
What are the main clinical features of osteomalacia
Wide spread bone pain
Lower limb weakness
Diagnosis or lab values for osteomalacia?
Low calcium
Low phosphate / high phosphate
High ALP and high PTH
Cause of osteomalacia
Reduce vit d
Which then has reduction of calcitriol ( active Vit D which 1,25 dihydroxy vitamin D )
Which then reduces the calcium re absorption from kidneys and intestines
Or
Insufficient calcium absorption from the intestine due to lack of calcium in diet
X
C
X
X
X
X
X
X
Lab values for osteoporosis / osteopenia ?
These are not quantifiable lab disorders
Normal calcium
Normal phosphate
Normal ALP
Normal PTH
Biggest cause for osteoporosis ?
Steroid consumption
Risk when taking atkeast 7.5mg of prednisolone or more every day for atleast 3 months
DEXA scan management in steroid induced osteoporosis ?
Between 0 and -1.5
Repeat bone density scan in 1-3 years
Less than -1.5
Offer bone protection
X
X
X
X
X
X
What is paget disease
bone remodelling disorder characterised by increased bone resorption, bone formation, and remodelling, which may lead to major long-bone and skull deformities.
What are the clinical features of Paget disease
Majority of patients are asymptomatic. Symptomatic patients typically experience pain localised to the bone or joint, either from the pagetic lesion
Neurological symptoms due to bone overgrowth with consequent nerve impingement may include hearing loss, chronic facial pain, hydrocephalus, peripheral nerve entrapment, and spinal stenosis.
long-bone or back pain
pathological fracture
bony deformities (e.g., frontal bossing, prognathism, bone bowing)
What is the diagnosis of Paget disease
incidental in the majority of patients, with an
isolated elevated serum alkaline phosphatase raising suspicion for disease.
Plain radiographs are diagnostic; in less clear cases, a computed tomography scan is indicated.
Bone biopsy is the ultimate confirmatory test, but it is rarely necessary.
What are the treatment options for paget disease
bisphosphonates are the first-line therapy to retard excessive osteoclastic activity.
Or Calcitonin
Adjunctive therapy includes physiotherapy, orthoses, and walking and hearing aids. Analgesics are indicated for pain control.
What are the increased risk factors for paget disease
More than 50
Family history
Make sex
