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Skeletal Pathology

Skeletal system
has 206 bones

Bone Fractures

A break in a bone
Types of bone fractures
Closed (simple) fracture break that does not
penetrate the skin
Open (compound) fracture broken bone
penetrates through the skin

Bone fractures are treated by reduction and


immobilization
Realignment of the bone

Common Types of Fractures

Table5.2

Repair of Bone Fractures

Hematoma (blood-filled swelling) is formed


Break is splinted by fibrocartilage to form a
callus
Fibrocartilage callus is replaced by a bony
callus
Bony callus is remodeled to form a
permanent patch

Stages in the Healing of a Bone


Fracture

Figure5.5

Anatomy of Bone

Structural Classification of
Joints

Fibrous joints
Generally immovable

Cartilaginous joints
Immovable or slightly moveable

Synovial joints
Freely moveable

Fibrous Joints

Bones united by fibrous tissue


Examples
Sutures
Syndesmoses
Allows more
movement than
sutures
Example: distal
end of tibia and
fibula
Figure5.27ab

Cartilaginous Joints

Bones connected by cartilage


Examples
Pubic
symphysis
Intervertebral
joints

Figure5.27de

Synovial Joints

Articulating
bones are
separated by a
joint cavity
Synovial fluid is
found in the joint
cavity

Figure5.24fh

Features of Synovial Joints

Articular cartilage (hyaline cartilage) covers


the ends of bones
Joint surfaces are enclosed by a fibrous
articular capsule
Have a joint cavity filled with synovial fluid
Ligaments reinforce the joint

Structures Associated with the Synovial Joint

Bursae flattened fibrous sacs


Lined with synovial membranes
Filled with synovial fluid
Not actually part of the joint

Tendon sheath
Elongated bursa that wraps around a tendon

The Synovial Joint

Figure5.28

Types of Synovial Joints Based


on Shape

Figure5.29ac

Types of Synovial Joints Based


on Shape

Figure5.29df

Inflammatory Conditions Associated with Joints

Bursitis inflammation of a bursa usually


caused by a blow or friction
Tendonitis inflammation of tendon sheaths
Arthritis inflammatory or degenerative
diseases of joints
Over 100 different types
The most widespread crippling disease in the
United States

Clinical Forms of Arthritis

Osteoarthritis
Most common chronic arthritis
Probably related to normal aging processes

Rheumatoid arthritis
An autoimmune disease the immune system
attacks the joints
Symptoms begin with bilateral inflammation of
certain joints
Often leads to deformities

Clinical Forms of Arthritis

Gouty Arthritis
Inflammation of joints is caused by a
deposition of urate crystals from the blood
Can usually be controlled with diet

Osteoporosis-disease
characterized
Osteoporosisby low bone mass & structural
deterioration of bone tissue

normal bone

osteoporotic bone

Skeletal
pathology

http://www.rad.washington.edu/mskbook/dysplasia.html

Osteochondroma

Osteochondroma

Osteosarcoma of Femur

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

metastatic
cancer
(radius)

Giant Cell
Tumor
Pelvis--left
ischial ramus

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Giant Cell Tumor--proximal femur


http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Bone metastases of spine & pelvis


dark spots indicate osteolytic lesions (destroy bone)

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

MRI scan of spine


demonstrates
metastatic lesion
destroying C7

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Osteopetrosis

Failure of
osteoclastosis

http://www.rad.washington.edu/mskbook/dysplasia.html

Note
unusual
bone
density

Pagets Disease
Note hazy
appearance of
cranium

http://www.amershamhealth.com/medcyclopaedia/Volume%20III%201/Pagets%20disease.asp

Radiograph-Scoliosis
(lateral
curvature of
spine)

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Mild scoliosis in
lumbar region

MRI of Spine
compression
fractures due to
osteoporosis
that results in
kyphosis

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Compression Fx.
Collapse of vertebra

Whats left of vertebral body

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Herniated disk
compressing spinal
cord.

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Osteoarthritis of
vertebral column

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Normal femoral
head removed after
fracture.

Note smooth
articular cartilage.

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Arthritic femoral
head removed due to
disease.

Note rough articular


surface.

Osteoarthritis
(proximal femur)

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Osteoarthritis
anterior/superior

patella & posterior


tibia

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Bunions

Rheumatoid Arthritis

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

Rheumatoid nodules at pressure points


of elbows

Gout from sodium urate crystals


deposited in joints.

Chronic gout eventually destroys bone.


Early stage of gout.

More advanced stage.

http://wwwmedlib.med.utah.edu/WebPath/BONEHTML/BONEIDX.html

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