Bone diseases 2014

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Bone diseases 2014

  1. 1. BONE DISEASES
  2. 2. BONE one of the hardest tissues of body Ch. Ch. By high elasticity Bone is a calcified collagenous matrix with some cells entrapped in-between
  3. 3. TYPES OF BONE 3types have been recognized 1- Lamellar bone = Mature bone 2- NON-Lamellar bone = Immature bone = WOVEN BONE 3- Bundle bone
  4. 4. Classification of bone diseases
  5. 5. BONE
  6. 6. = Osteitis Fibrosa Cystica = Von Recklinghausen's disease of bone Hyperparathyrodism =  PTH In 2ry hyperparathyroidism, high levels of PTH do not cause hypocalcaemia 2 Types (1ry, 2ry hyperparathyroidism) are harmful to bone????!!!
  7. 7. Clinical features
  8. 8. BONE
  9. 9. Fibrous Dysplasia of bone Bone is replaced by Fibrous C.T Fibrous Dysplasia of boneFibrous Dysplasia of boneFibrous Dysplasia of bone Bone is replaced by Fibrous C.T proliferating gritty Bone resorption Fibrous replacement Ossous metaplasia Woven Bone
  10. 10. Fibrous Dysplasia of bone Etiology ??!! 1. Non- Neoplastic growth 2. Abnormal reaction to traumatic episode. 3. Endocrinal disturbances. TYPES
  11. 11. Monostotic Fibrous Dysplasia = fibrous dysplasia confined to a single bone, 6 times as polyostotic Age 1st or 2nd decade of life (4-18 years) Sex ♀ = ♂ Site affects only one bone particularly the jaws. Max. > Mand. S&S Slowly growing painless swelling…. not well circumscribed (diffuse) smooth and covered e normal mucosa. Disfiguring stabilization and expansion stops with skeletal maturation.
  12. 12. Age 1st or 2nd decade of life (4-18 years) Sex ♀ = ♂ Site affects only one bone particularly the jaws. Max. > Mand. S&S Slowly growing painless swelling…. not well circumscribed (diffuse) smooth and covered e normal mucosa. Disfiguring stabilization and expansion stops with skeletal maturation.
  13. 13. Polystotic Fibrous Dysplasia = fibrous dysplasia involve multiple bones, up to 75% of skeleton Age 1st or 2nd decade Sex ♀>♂ Site involves several bones including long bones, skull and jaws. S&S Slowly growing painless swelling…. not well circumscribed (diffuse) smooth and covered e normal mucosa. Disfiguring stabilization and expansion stops with skeletal maturation. Jaffe 's syndrome Albright’s syndrome Polystotic fibrous dysplaisa Café au lait skin pigmentation Endocrinal disturbances Polystotic fibrous dysplaisa Café au lait skin pigmentation
  14. 14. Oral manifestation
  15. 15. Radiographic features 1. Mottled or Mixed 2. Radio-opaque. Lesions merge with normal bone at the margins (= ill defined) Lesion differ radiographoically according degree of osseous metaplasia
  16. 16. Histopathological features
  17. 17. Treatment Self limiting Cosmotic surgery may be needed
  18. 18. BONE
  19. 19. Paget’s disease of bonePaget’s disease of bone 2nd most common osteodystrophic condition after osteopetrosis 1. Inflammatory disease (Paget's original believe). 2. Autoimmune disease. 3. Endocrine abnormality related to hyperthyroid disease. 4. vascular disorder. 5. Bone remodling disturbance. 6. viral infection (paramyxo v. + measles + RSV) Etiology ??!!Phases
  20. 20. Age uncommon before age 40 (=  40 years) Sex ♂> ♀ (2:1) Site vertebral column (1st most common site) - Sacrum > Lumbar > Thoracic > Cervical vertebrae. - mechanical stress i.e bearing most wt. being most affected Skull (next most frequently affected) - mand. & max. about 17% of cases. - Max.> Mand. - functional stress + traction of neck muscles + stresses of mastication S&S severe pain. Bones become larger…. flat bones become thicker.  round bones  in circumference hats and dentures may no longer fit. Weight bearing bones……  bend under pressure  crippling + bowing deformities.  break easily. Deafness and Blindness , d.t. narrowing of cranial foramina. High cardiac output failure may occur due to arteriovenous shunt. Clinical features
  21. 21. Clinical features
  22. 22. Clinical features
  23. 23. Clinical features
  24. 24. Clinical features
  25. 25. Clinical features
  26. 26. Radiographical features
  27. 27. Histopathological features
  28. 28. BONE A) Affects membranous bone B) Affects endochondral bone C) Affects both types of bone OI , cherubism , osteopetrosis achondroplasia Cleido-cranial dysplasia
  29. 29. Cherubism = familial fibrous dysplasia = familial multilocular cystic disease of jaws Age early childhood bn (2-4 years) Sex ♂ > ♀ Site Mand.> Max. S&S Bilateral ,Firm, painless swelling at angles of mand. Clinical features Pathogenesis

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