Lecture Notes: Skeletal Pathology Overview

Introduction

• Main Topics:
  • Brief review of anatomy and physiology of the skeletal system
  • Pathologies: occurrence, signs, symptoms, diagnosis, treatment
  • Radiographic techniques for various pathologies

Anatomy and Physiology

• Human Skeletal System:
  • 106 separate bones
  • 126 bones in the appendicular skeleton, 80 in the axial skeleton
  • Composed of calcium, phosphate; functions include support, protection, movement, blood cell production
• Bone Structure:
  • Compact bone (outer), cancellous bone (inner); medullary canal contains red and yellow marrow
  • Bone cells:
    - Osteoblasts (form bone)
    - Osteoclasts (break down bone)
• Bone Classifications:
  • Diaphysis (main shaft), epiphysis, metaphysis (growth zone)

Types of Joints

• Fibrous/Immovable (Synarthrodial):
  • e.g., skull sutures
• Cartilaginous/Slightly Movable (Amphiarthrodial):
  • e.g., intervertebral joints
• Synovial/Movable (Diarthrodial):
  • e.g., knee joint

Pathologies of Interest

Osteogenesis Imperfecta

• Types:
  • Congenita: Apparent at birth
  • Tarda: Occurs 5–15 years after birth
• Characteristics:
  • Mutations in collagen-producing genes

Achondroplasia

• Description:
  • Common inherited disorder (dwarfism)
  • Characterized by mid-face hypoplasia, flaring at metaphysis

Osteopetrosis

• Description:
  • Increased bone density, heavy but brittle bones
  • Requires increased radiographic technique

Hand and Foot Malformations

• Types:
  • Syndactyly: Failure of digits to separate
  • Polydactyly: Extra digits
  • Clubfoot (talipes): Treated with casting/splinting

Vertebral and Cranial Anomalies

• Scoliosis:
  • Abnormal lateral curvature of the spine
• Transitional Vertebra:
  • Cervical or lumbar ribs
• Cranial Anomalies:
  • Cranial stenosis, anencephaly

Osteomyelitis

• Description:
  • Infection of bone or bone marrow
  • Sequestrum (dead tissue), involucrum (new bone)

Arthropathies

• Arthritis Types:
  • Rheumatoid, juvenile rheumatoid
  • Ankylosing spondylitis, osteoarthritis
  • Gouty arthritis: Uric acid deposits, dual-energy CT for diagnosis

Vertebral Column Injuries

• Whiplash, Spondylolisthesis, Spondylolysis:
  • Soft tissue injuries, vertebral slippage

Neoplasms

• Benign:
  • Osteoma, osteochondroma, giant cell tumor
• Malignant:
  • Osteosarcoma, Ewing’s tumor, metastases

Radiographic Considerations

• Importance of determining additive vs subtractive diseases
• Techniques vary depending on pathology presence

Note: These notes cover the key points of skeletal pathologies, including their definitions, characteristics, and diagnostic considerations, which are crucial for understanding and managing these conditions effectively.