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Hemopoitic Tissue
Storage for Ca+2, PO 4-2, Mg+, Na+2
Generalized Reaction of Bone
A. Bone Deposition > Bone Resorption
Examples
Osteopetrosis
Acromegaly
“Bone within a bone”
Fx. 4th metahead denote to
the fragility of the bone in
this disease
B. Bone Deposition < Bone Resorption
Examples
Osteoporosis
Rickets/Osteomalacia
Osteogenesis Imperfecta
Thyroid Acropachy
Macrodystrophia
Lipomatosis
Neurofibromatosis
Marfan’s Syndrome
Hypertrophic
Osteoarthropathy
Caffey’s Disease
Tuberous Sclerosis
Clinical triad of convulsive seizures, mental deficiency and
adenoma sebaceum.
Pycnodysotosis
Melorheostosis
Localized Reactions of Bone
A. Bone Deposition > Bone Resorption
• Work Hypertrophy
• DJD
• Fractures
• Infections
• Osteosclerotic Neoplasms
melorheostosis
osteopoikilosis
Paget’s disease
B. Bone Deposition < Bone Resorption
• Disuse Atrophy (osteopenia)
• Rheumatoid Arthritis
• Infection
• Osteolytic Neoplasms
Madura foot
Reaction of Epiphyseal Plates to Injury
• Increase Growth
• Decrease Growth
• Torsional Growth
Generalized Reaction to Epiphyses
• Increase in Growth (Gigantism)
– Arachnodactly (Marfan’s Syndrome)
– Pituitary Gigantism
Apert’s syndrome
Macrodactaly possibly hemangioma
Decrease in Growth
• Arachnoplasia
• Pituitary dwarfism
• Rickets
Localized Reactions to Epiphysis
• Increase in Growth
Chronic Infection
Displaced Fractures
Congenital A-V Malformations
Localized Reactions to Epiphysis
• Decrease in Growth
– Disuse
– Injury
– Thermal Injury
– Ischemia
– Infection
Reaction of Articular Cartilage
• Destruction
• Degeneration
• Peripheral Porliferation
Reaction of Synovial Membrane
• Increase in Fluid ( Effusion)
• Hypertrophy
• Adhesions
Reaction of Joint Capsule & Ligaments
• Joint Laxity
• Contracture
Rickets
• Failure of Ca++ salt to be Deposited into
the Matrix
• Clinical Enlargement at the Site of the
Epiphyseal Plate
• Widened Radiolucent Zone
• Recalcification of all Bones
Renal Rickets
Scurvy
• Failure of Osteoblastic Formation of Bone
Matrix
• Subperiosteal and Mucosal Hemmorhage
Scurvy
• Clinical Picture
– Irritability
– Pain
– Swelling
– Gingival Bleeding
Scurvy
• Radiographic Findings
– Osteoporosis
– Dense White Line on Metaphyseal Side of
Epiphyseal Plates
– Soft Tissue Shadows
Differential Diagnosis
• Paralysis
• Osteomyelitis
• Congenital Syphillis
• Child Abuse
Battered child syndrome
Avitaminosis C
• Pain
• Caumesthisias
• Baresthesia
• Bruising
• Muscle Fatigue