1. SKELETAL DISEASES NOTES

2. Osteoporosis: What is it?  Loss of bone density and mass  Bones become more porous, increasing risk of fractures

3. Osteoporosis 52 year old Female84 year old Female

4. Osteoporosis: Causes  More common in women, especially of Asian and European descent  Aging leads to a loss of osteoblasts  loss in bone density  With the onset of menopause (mid-forties to fifties), diminishing estrogen levels lead to excessive bone resorption (osteoclast activity)

5. Osteoporosis: Treatment Age:  Vitamin D and calcium supplements  drugs that slow bone loss  frequent moderate exercise (help make bones stronger) Menopause:  drugs that raise estrogen levels

6. Arthritis: What is it?  Rheumatoid arthritis is an autoimmune (body attacking itself) disease which causes joint stiffness and bone deformity  Inflammation and swelling of flexible joints, destruction of articular cartilage, and ankylosis (fusion of joints)

7. Arthritis

8. Arthritis: Causes  Osteoarthritis is caused by wear and tear on articular cartilage due to age, injury, frequent use, or infection.  Rheumatoid arthritis is an autoimmune disease where antibodies attack articular cartilage leading to inflammation etc. While its cause is unknown, there is a genetic component and smokers are at increased risk.

9. Arthritis: Treatment Depends on the cause…  Anti-inflammatory drugs (Advil, steroids)  cold-packs  immune-suppressing drugs (rheumatoid)  Physical Therapy (PT)  Surgery  Stem cells  regrow cartilage

10. Scoliosis: What is it?  An abnormal curvature of the spine from side-to-side. Often not painful, but can be. Most often diagnosed and develops in adolescence. Also seen in elderly patients.

11. Scoliosis: Causes  Mostly unknown. Can develop from problems in other parts of the body (spina bifida, cerebral palsy), arthritis, improper development of the spine at birth, or have genetic causes.

12. Treatment  Bracing, surgery, PT, and chiropractics (older patients)

13. Rickets: What is it?  Softening of bones which can lead to bone tenderness, bow-legged posture, improper skeletal development, tetany (uncontrolled muscle spasms)

14. Rickets

15. Rickets: Causes 1. Vitamin D deficiency 2. Lack of calcium in diet  Vitamin D is required for proper calcium absorption  Vitamin D is produced when you are exposed to sunlight (UV rays). Darker-skinned people require longer exposure to sunlight  Rarely seen in developed countries. Most commonly seen today in developing countries where children are malnourished.

16. Treatments  Vitamin D supplement + Calcium supplement in diet  Exposure to sunlight

17. Rickets  Children in developed nations don’t go outdoors as much and often play inside on their electronic devices. Why do you think rickets are not a problem then for children in these countries?  Milk + Vitamin D

18. Blount’s Disease: What is it?  Bow-leggedness that becomes progressively worse with age. Often seen in children and adolescents. Associated with overweight individuals.

19. Blount’s Disease: Causes  The inner part of the tibia under the patella fails to develop properly leading to a slanting of the bones, angled inward.  This developmental failure is often the result of extra stress placed on the tibia with obese individuals

20. Blount’s Disease

21. Blount’s Disease: Treatment  Bracing  Surgery  Diet/Exercise to promote long-term success of treatment

22. Sprain: What is it?  Usually painful  Injured portion often swells and may turn black and blue  Occurs at joints. Result of an injury to a ligament or to the tissue that covers a joint.

23. Sprain: Causes  Most sprains result from a sudden wrench that stretches or tears the tissues of the ligaments.  Common in athletes

24. Sprain: Treatment  RICE:  Rest (first 48 hours using crutches, splint)  Ice (first 48 hours for 20 minutes every 3-4 hours)  Compression (wrap it snuggly)  Elevate (higher than heart)

25. Kyphosis: What is it?  Deformity of the upper portion of the spinal column that results in severe forward bending of the spine (hunchback)

26. Kyphosis

27. Kyphosis: Causes  In children and adolescents, this condition may result from poor posture, misshapen vertebrae or problems during fetal development.  In adults, this condition is often the result of another disease, such as arthritis, osteoporosis, trauma, or cancer

28. Kyphosis: Treatment  Exercise/Physical Therapy (if minor)  Bracing (moderate)  Surgery (severe)