Fractures, Osteonecrosis, Osteomyelitis Flashcards Preview

MS/Rheum > Fractures, Osteonecrosis, Osteomyelitis > Flashcards

Flashcards in Fractures, Osteonecrosis, Osteomyelitis Deck (42)
Loading flashcards...
1
Q

The bone fractures after repeated extra stress, i.e., there were some tiny microfractures (as in osteoporosis)

A

stress fracture

2
Q

The bone is cracked, but not broken into two pieces

A

incomplete fracture

3
Q

What is a greenstick fracture?

A

incomplete fracture in kids that results from impact to thier “supple” long bones

4
Q

closed fracture

A

overlying tissue is in fact

5
Q

The bacteria have a route from the surface to the bone; perhaps the bone is even sticking out the wound.

A

compound, open fracture

6
Q

The bone is broken into several pieces.

A

multifragmented (comminuted) fracture

7
Q

A curious term for a fracture in which the ends of the bone fragments have done serious damage to the surrounding tissue.

A

complex fracture

8
Q

Due to intrinsic disease of the bone; the force would not have broken a normal bone. Seen in osteoporosis, cancer, osteogenesis imperfecta.

A

pathologic fracture

9
Q

Describe the process of callus formation after a bone fracture

A
  1. bleeding and formation of clot
    • devascualrization of edges of fractured/dead bone
  2. recruitment and ingrowth of neovascualization
  3. fibroblasts organize clot
  4. removal of dead cortex
  5. ingrowth of osteocytes
  6. new/woven bone formation
  7. cartilage produced at surface of callus
  8. continued remodeling (over months)
  9. complete bone healing (loss of cartilage cap)
10
Q

T or F: the fractured ends of bone must be perfectly aligned to begin the process of healing/callus formation

A

F: but they must be in close proximity

11
Q

What happens if the fractured ends of a bone are not in close enough proximity for healiing?

A

the callus cannot form an there is a “fibrous nonunion” of the ends
= fibrous replacement of tissue between the ends

**pathologic

12
Q

Microscopically, during bone healing, fractured bony spicules are being joined together by…

A

new osteiod

13
Q

Why are metal pins surgically inserted after some fractures?

A

to produce the conditions necessary for appropriate callus formation and bone healing.

= align the ends

14
Q

Where on the bone does osteonecrosis most likely occur?

A

convex surface of joints

*usually spares the synovium/joint space

15
Q

What is the feared result of osteonecrosis

A

detachment of the articular cartilage

16
Q

osteonecrosis can be a complication of what 3 conditions?

A
  1. femoral neck fracture or disslocation
  2. sickle cell
  3. decompression sickness
17
Q

Osteonecrosis has a mysterious link to..

A

alcohol abuse and glucocorticoid use

18
Q

How can sickle cell disease lead to osteonecrosis?

A

sickled RBCs occlude vessel

hypercellularity of the marrow can interfere with normal blood flow in the marrow

19
Q

soft tissue swelling with periosteal new-bone formation and a moth-eaten lytic process

A

hand foot syndrome

*seen in sickle cell dz

20
Q

XR manifestation of bone with chronic infarcts and secondary osteoarthritis (seen in sickle cell)

A

irregular sclerosis and lucency (infarcts)
bone-in-bone appearance (infarcts)

narrowed cartilage and irregular joint surfaces (OA)

21
Q

Bone within bone appearance on XR can indicate

A
  • **sclerosis, resulting from multiple infarctions

* think sickle cell dz

22
Q

osteomyelitis is caused by ___ organisms that spread

A

pyogenic
*most commonly staphylcoccus (80-90%)

that spread hematogenously, contiguously, or in pts with vascualr insufficiency

*hematogenous is most common in kids

23
Q

What are risk factors for developing osteomyelitis

A
DM 
periph vascualr dxz
sickle cell 
congenital phagocyte function defect 
presence of foreign materials
ortho surgery 
adjacent infections
24
Q

TB osteomyelitis

Name of dz?
what bones are affected?

A

Pott Dz

vertebrae (causes collapse –> kypohosis)

25
Q

What organism is assc with osteomyelitis in sickle cell pts

A

salmonella

26
Q

Mixed bacterial osteomyelitis is assc with

A

trauma or surgery

27
Q

congenital syphilitic osteomyelitis is assc with

A

saber shins and saddle nose

mom passes syphillis to fetus

28
Q

chronic osteomyelitis can give rise to

A

squamous cell carcinoma

29
Q

On what part of the bone does osteomyelitis typically begin

A

metaphysis

spreads internally and externally from here +/- sinsus tracts

30
Q

sinus tracts in bone

A

osteomyelitis

31
Q

In chronic osteomyelitis what is happening outside the bone and inside the bone at the site of infection?

A

outside = bone growth = reactive = involucrum

inside = bone necrosis = partial reabs = sequestration

32
Q

subperiosteal shell of viable new bone

A

involucrum

*chronic osteomyelitis

33
Q

inner necrotic cortex

A

sequestrum

*chronic osteomyelitis, necrosis is purulent

34
Q

empty lacunae in spicules implies

A

dead bone

35
Q

T or F: poly predominant in CHRONIC osteomyelitis

A

T

NO LYMPHOCYTES present

36
Q

What immune cells are present in acute osteomyelitis? Chronic?

A

neutrophils! NO lymphocytes

prob some fibroblasts and maybe macrophages too

37
Q

marked ulceration and necrosis of calcaneus

A

osteo in DM

38
Q

spinal tuberculosis is a combined infectious of

A

vertebral bodies (spondylitis) and joint spaces (spondylarthritis)

39
Q

gibbus deformity

A

severe kyphosis from vertebral collapse

  • can be seen with Pott Dz
40
Q

manifestation of primary syphillis

A

chancre = skin lesion at point of contact (usually genitals or anus)
*can last 4 to 6 weeks and heals spontaneously

41
Q

manifestation of secondary syphillis

A
  • 1-6 mos after primary
  • Chondylomata lata: symmetrical reddish-pink non-itchy rash on the trunk and extremities (can be on palms and soles) that contain ACTIVE treponeme = CONTAGIOUS
42
Q

manifestations of tertiary syphillis

A

-1-10 years after primary

  • gummas = chronic soft, tumor like granulomas due to the immune sys inability to clear the org
  • -> chronic infalm state
  • neuropathic joint dz = degeneration of joint surfaces –> loss of sensation and fine position sense (proprioception)
  • neuro syphillis
  • CV syphillis

Nolan Never Gets Cold bc he has the syph