Bone Pathology

Question 1

Bone histology features

Answer 1

Lacunae (osteocytes present)

Circumferential lamellae

Interstitial lamellae

Periosteum

Osteon

Volkmans Canal

Haversian canal

Question 2

Modes of bone remodelling (3)

Answer 2

• Mechanical stimuli
• Systemic hormones
  PTH, Vit D, Oestrogen
• Cytokines
  Interleukin 1+6

Question 3

Special tests for bone pathology (5)

Answer 3

Blood Calcium
Osteoblast activity
Osteoclast activity
PTH
Vit D

Question 4

What is osteogenesis imperfecta?

Answer 4

Type I collagen defect

Question 5

Clinical presentation of osteogenesis imperfecta (4)

Answer 5

Brittle bones
Blue sclera
Early hearing loss
Multiple bone fractures

Question 6

What does rarefying osteitis mean?

Answer 6

Not diagnosis

PAP, PA granulomas/abscesses/cysts

Question 7

Name examples of developmental bone abnormalities (4)

Answer 7

• Osteogenesis Imperfecta
• Achondroplasia
• Osteopetrosis
• Fibrous dysplasia

Question 7

Name examples of developmental bone abnormalities (4)

Answer 7

• Osteogenesis Imperfecta
• Achondroplasia
• Osteopetrosis
• Fibrous dysplasia

Question 8

What is achondroplasia?

Answer 8

Autosomal dominant

Poor endochondral ossification

Question 9

Clinical features of achondroplasia

Answer 9

Dwarfism

Shortened long bones

Frontal bossing

Question 10

What is ostepetrosis?

Answer 10

Decreased bone resorption due to impaired function of osteoclasts (too much bone)

Question 11

What if fibrous dysplasia?

Answer 11

Gene defect

Slow growing asymptomatic bony swelling

Question 12

Histology of fibrous dysplasia

Answer 12

No capsule

No osteoblasts

Cellular fibrous tissue

Question 13

Reasons for bone necrosis (3)

Answer 13

Osteomyelitis
Avascular necrosis
Irradiation

Question 14

What is osteoporosis

Answer 14

Too little bone
Resorption exceeds formation

Question 15

Aetiology of osteoporosis

Answer 15

Ca status
Physical activity
Age

Question 16

Different types of Hyperparathyroidism

Answer 16

Primary
Secondary
Tertiary

Question 17

Cause of rickets

Answer 17

Vit D deficiency
Low calcium

Lack of sunlight
Diet
Malabsorption

Question 18

Examples of giant cell lesions of the jaw

Answer 18

Peripheral giant cell epulis
Central giant cell granuloma

Question 19

What is cherubism?

Answer 19

Abnormal bone disorder
Autosomal dominant inheritance

Question 20

What is pagets?

Answer 20

Decreased bone turnover

Question 21

Who does pagets affect?

Answer 21

M>F
>40

Question 22

Serum biochemistry for pagets

Answer 22

Increased alkaline phosphatase

Question 23

Clinical presentation of pagets

Answer 23

Bone swelling
Pain
Nerve compression
Increase in size of skulll

Complain about dentures getting tight over time

Question 24

Stages of Pagets

Answer 24

1. Lytic - bone resorption
2. Mixed - resorption + deposition
3. Sclerotic - deposition

Question 25

Dental relevance of lytic stage

Answer 25

Heavy bleeding during XLa
Active stage

Question 26

Dental relevance of sclerotic stage

Answer 26

Hardly any bleeding

Increased dry socket + necrosis due to compressed BS

Question 27

Dental changes in regards to Pagets (4)

Answer 27

• Loss of lamina dura
• Hypercementosis
• Migration
• Bulging of root

Question 28

Histology of Pagets

Answer 28

Osteoblasts + osteoclasts

Question 29

Name 2 benign bone tumours

Answer 29

Osteoma

Osteoblastoma