*Nuclear MedicineHas advantage over CT & MRI because it can
scan the whole body at one time
Can show if an injury is old or new
Still the standard for examination of metastatic processes
because it demonstrates metabolic reaction of bone to the disease
processIs more sensitive than comparative radiographic studies
Compact bone: outer portion
Medullary canal- inner portion made of cancellous bone. Bone
marrow is located within medullary canal ad it is interspaced with
Trabeculae: web like bony structure. Can be seen on a properly
Diploe: cancellous bone located within the skull.
Red bone marrow: found in normal adult bones of the trunk. At 20
years of age the majority is replaced by yellow bone marrow which
is primarily fat.
Osteoblasts: bone forming cells that line the medullary canal
and are interspaced throughout the peristeum. Responsible for bone
growth and thickening, ossification and regeneration.
Osteoclasts: break down bone to enlarge the medullary canal and
allow for bone growth.
*Diaphysis: refers to the shaft portion of the long bones.
Primary site of ossification.
Epiphysis: expanded end portion and its the secondary site of
Metaphysis: growth zone between the epiphysis and diaphysis.
There is a growth plate between the metaphysis and epiphysis
made of cartilage. Appears radiolucent until child grows and it
Peristoeum: fibrous membrane that encloses all the bone except
the joint surfaces.
The more physical stress the bone is under the more thickly the
compact bone becomes.
*Deficient formation of osseous tissue, skin , slcera, inner ear
2 Main groups:1) Congenita- present at birth and there are
multiple fractures at birth. Limb deformities and dwarfism that may
lead to death.
2) Tarda- fractures may not appear until some years after birth
and then generally stop once adulthood is reached. They often have
hearing disorder that persists called otoslcerosis. Otosclerosis is
abnormal connective tissue around auditory ossicles.*Most common
inherited skeletal disorder.
Results in bone deformity and dwarfism. Does not skip
generations and 50% of passing it to children.
Cartilage on epiphysis of the long bones does not convert to
bone; impairs longitudinal growth of the bones.
Normal trunk size and shortened extremities. Usually no taller
than 4 ft.
Other symptoms include extreme l-spine lordosis, bowed legs,
bulky forehead, and narrowing of the foramen magnum.
*Increase in bone density and defective bone contour.
Bones are heavy and compact but brittle.
All bone are affected but primarily the bones of the
extremities, vertebrae, pelvis and base of the skull.
Radiographs show increase density and thickness of bony cortex
as well as an increase in the number and size of trabeculae with
reduction of bone marrow space. *Lateral curvature of the spine.
Convex to the RT on the t-spine and convex to the LT on the
80% are idiopathic
Can generate complications such as cardiopulmonary
complications, degenerative spinal arthritis, fatigue, joint
Non-structural scoliosis-results from uneven leg length or
postural changes due to chronic pain elsewhere in the body.*AT C7
it can exert pressure on brachial nerve plexus or subclavian artery
requiring removal. *7 criteria for diagnosis of RAMorning stiffness
in and around the jointsSimultaneous soft tissue swelling or fluid
of at least 3 joint areas lasting for at least 6 weeks and observed
by and MDArthritis hand joints-at least one area swollen in a PIP,
MCP or wrist joint for at least 6 weeks.Rheumatoid nodules or lumps
of tissueAbnormal amounts of serum RFSymmetric arthritic-
simultaneous involvement of the same joint areas on both sides of
the body for at least weeks. Radiographic changes demonstrating
bone erosion and decalcification
*Occurs in 30-40 years and affects women 3xs more than men.
As the disease progresses cortical erosion with joint space
narrowing occurs b because of overgrowth of synovial tissue in the
articualr spaces. This damage makes joint unstable and leads to
deformity caused by displacement of bones.
Can result in subluxation and dislocation eventually leads to
fusing. Sometimes surgical intervention is needed to correct these
pathologies.synovium excisiondislocation correctionjoint
*Affects men/women equally. Asymptomatic until 50s.
Generally affects the LG weight bearing joints such as the hip
Loss of cartilage appears as joint narrowing. Overgrowth of
cartilage occurs in the peripheral surfaces of the joint and
calcifies- bone spurs. The bone spurs or osteophytes are what
distinguish one arthritis from the other.
NSAIDS and exercise are the best treatment.
*Pathogenic microorganisms spread via the bloodstream.
Contiguous infetions- burns, sinus disease, peridontal
infection, soft tissue infection and peripheral vascular
NUC med and MRI are better for imaging this pathology.
*Progressive type of arthritis mainly affecting the spine.
Usually affects men 20-40 years old.
Symptoms: low back pain at night, morning stiffness, weight
loss, low grade fever, fatigue and anemia.
Early radiographic signs include narrowing and fuzziness of SI
joints. Eventually there are no SI joints and disease progresses up
Disk space calcifies and bone of the spine fuses.
Treated with NSAIDS, exercise and postural training.
*Inherited metabolic disorder in which uric acid is deposited
into the joint and adjacent bone. Occurs more frequently in men and
most commonly in the metatarsalphalangeal joints of the great
The crystallization causes an inflammatory action.
Treatment includes medications to promote excretion of uric acid
or to inhibit the production of uric acid.
*Refers to the anterior slipping of the body of the
Symptoms are similar to those of a slipped disk. 90% occur at
L5-S1, best detected on a lateral projection.
*Most common benign bone tumor
Affects men 3xs more than women. Arises in the metaphysis. Most
commonly involves lower femur and upper tibia.
Cortex blends with normal bone, growth protrudes upward and away
form the nearest joint and most commonly in the knee.
Many times it is asymptomatic until trauma occurs.*Most
frequently found in the metahysis of the long bones and 50% affect
75% of patients are under 20 years
Most commonly in bone marrow and it is highly aggressive.
*Generally occurs in the metaphysis of long bones in patients
under 20 years. Slow growing.
Symptoms include pain and swelling at the site of cyst.
Cystic growth causes thinning of the bony cortex that is
apparent radiographically. It is a well-circumscribed lesion
associated with soft tissue extension and peristeal bulging. *