Musculoskeletal System

Question 1

What are three types of bone disease

Answer 1

Congential

Acqiured

Inflammatory

Question 2

Two congenital bone diseases include:

Answer 2

Osteogenesis imperfecta

Osteopetrosis

Question 3

Two acquired bone diseases include:

Answer 3

Osteoporosis

Paget’s disease

(Osteitis deformans)

Question 4

An example of an inflammatory bone disease is _____

Answer 4

Osteomyelitis

Question 5

ID this bone disease

Answer 5

Osteogenesis Imperfecta

“Brittle Bone Disease”

Question 6

Describe OI

What is the pathogenesis of OI?

Answer 6

A group of hereditary conditions characterized by abnormal development of Type I collagen

Pathogenesis:

Gene mutations in the coding sequence of Type I collagen

Question 7

Clinical issues and features of OI:

Answer 7

Bone fractures occur with minor trauma

Orally: “dentinogenesis imperfecta,” defective dentin

Hearing loss

Blue sclera - caused by decreased sclera collagen

Question 8

What is Osteopetrosis?

Answer 8

“Stonebone”

Reduced osteoclast-mediated bone resorption with defective bone remodeling

Bone is easily fractures like a piece of chalk

Marked increase bone density on radiographs

Question 9

Clinical features of Osteopetrosis:

Answer 9

Fractures

Cranial nerve problems due to compression from surrounding bone

Obliteration of bone marrow

Question 10

What can obliteration of bone marrow lead to in Osteopetrosis?

Answer 10

Reduced hematopoiesis

Recurrent infections

Normocytic anemia

Question 11

What is Osteoporosis?

Answer 11

A disease characterized by increased porosity of the skeleton resulting from reduced bone mass

Question 12

Characteristics of Osteoporosis

Answer 12

Spine and femoral neck are prone for fractures

Idiopathic or secondary to corticosteroids or multiple myeloma

Question 13

Morphology of Osteoporosis

Answer 13

Bony trabeculae are thin and widely spaced leading to an increased susceptibility to fracture

Severe in vertebral bodies and femoral necks (weight- bearing bones)

Mineral content is normal

Question 14

Clinical course and Treatment of Osteoporosis

Answer 14

Loss of height and kyphoscoliosis

Femoral neck fractures results in immobilization may lead to pulmonary embolism and pneumonia

Tx: Calcium and Vit D supplementation

Weight bearing exercise

Biphosphonates - decrease osteoclast-mediated bone resorption

Question 15

Why should a dentist beware of bisphosphonates?

Answer 15

Inhibitors of osteoclastic activity and bone remodeling

Jawbone surgery should be approach with caution

Jawbone problems due to IV use principally

• Osteochemonecrosis

Question 16

Paget’s Disease (Osteitis Deformans) is characterized by:

Answer 16

Frenzied osteoclastic activity followed by exuberant bone formation by osteoblastic activity

The excess bone is architecturally abnormal and unstable

Question 17

Pathogenesis of Paget’s Disease (Osteitis Deformans):

Answer 17

Idiopathic

Possible paramyxovirus association

Question 18

What are the three phases of development of Paget’s Disease?

Answer 18

Osteoclastic: Bone loss, Hypervascularity

Osteoclastic and Osteoblastic

Osteoblastic: Formation of dense, mineralized bone

Question 19

Features of Paget’s Disease

Answer 19

Uncommon before 40

Male > Female

Bone lesions may be solitary (monostotic) or multifocal (polyostotic)

Question 20

Most cases of Paget’s disease are ___ostotic

Answer 20

Polyostotic

Question 21

Most common locations for Paget’s Disease

Answer 21

Spine

Skull

Pelvic bones

Question 22

Major Clinical Features of Paget’s Disease

Answer 22

Bone pain = MOST COMMON

Secondary osteoarthritis

Bony deformity (bowing)

Excessive warmth (hypervascularity)

Neurologic complications (neural tissue compression)

Question 23

Diagnosis of Paget’s Disease

Answer 23

Elevated serum alkaline phosphate (due to increased osteoblastic activity)

Serum calcium and phosphate = normal

1% develop an osteosarcoma (usually in pelvis; poor prognosis)