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Skeletal System

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... normal fat pads and progresses to a ragged,, 'moth-eaten' appearance of the bone. ... fracture of the ring of the atlas that involves both the anterior and ... – PowerPoint PPT presentation

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Title: Skeletal System


1
Skeletal System
2
Physiology of the Skeletal System
  • Periosteum
  • Fibrous membrane covering the surfaces of bone
  • Diaphysis
  • The main shaft like portion of long bones
  • Epiphysis
  • The ends of the bone

3
Physiology of the Skeletal System
  • Medullary or marrow
  • The hollow tube like structure within the
    diaphysis
  • Endosteum
  • Lines the medullary canal

4
Two types of bone
  • Compact bone
  • The outer layer of bone
  • Cancellous (spongy) bone
  • The inner matrix of bone

5
Ossification Process
  • Osteoblasts
  • Produces new bone around outer circumference of
    bone
  • Osteoclasts
  • Absorbs old bone and increases the diameter of
    the medullary cavity

6
Congenital Anomalies of the Skeletal System
  • Transitional vertebra
  • A vertebra that takes on the characteristic of
    the vertebra on either side of it.
  • Example a cervical vertebra with a rib attached

7
Congenital Anomalies of the Skeletal System
  • Spina Bifida
  • A posterior defect of the spinal canal resulting
    from failure of the posterior elements to fuse
    properly
  • Radiographic Findings
  • Depending on the location of the malformation and
    severity, various anomalies may exist.

8
Congenital Anomalies of the Skeletal System
  • Osteopetrosis Marble Bone
  • There in an increase in bone resorption
  • Radiographic Findings
  • Very dense bone which usually need increased
    technical factors

9
Congenital Anomalies of the Skeletal System
  • Osteogenesis imperfecta Brittle Bone Disease
  • The skeleton does not ossify properly.
  • Often characterized by a blue coloration of the
    white sclera of the eye
  • Radiographic Findings
  • Thin cortical outlines allowing for fracture with
    minimal trauma

10
Congenital Anomalies
  • Osteogenesis Imperfecta
  • Brittle Bone Disease

11
Congenital Anomalies of the Skeletal System
  • Acondroplasia
  • Failure of cartilage that becomes bone to form
    properly
  • Causes dwarfism
  • Radiographic Findings
  • Posterior scalloping of lumbar vertebral bodies

12
Congenital Anomalies
  • Achondroplasia

13
Metabolic Bone Disease
  • Osteoporosis
  • Generalized or localized deficiency of bone
    matrix.
  • Major causes are aging and postmenopausal
    hormonal changes.
  • Radiographic Findings
  • Cortical thinning with irregularity and
    resorption of the inner surfaces.
  • Most evident in spine and pelvis.

14
Metabolic Bone Disease
  • Osteomalacia
  • Insufficient mineralization of the adult
    skeleton.
  • Radiographic Findings
  • Appears as a loss of bone density.

15
Non-Neoplastic Bone Changes
  • Osteomalacia
  • rickets

16
Metabolic Bone Disease
  • Rickets
  • Systemic disease of infancy and childhood that is
    equivalent of osteomalacia in the mature
    skeleton.
  • Radiographic Findings
  • Early changes are best seen in the fastest
    growing portions of bone (sternal ends of ribs,
    proximal ends of tibia and humerus, distal ends
    of radius and ulna).

17
Metabolic Bone Disease
  • Gout
  • An increase in the levels of uric acid in the
    joint.
  • Radiographic Findings
  • Appearance of cystlike lesions

18
Mertabolic Bone Disease
  • Paget Disease (osteitis deformans)
  • A destruction of bone in which soft bones are
    constantly replaced with calcified bone that
    causes and enlargement known as acromegaly
  • Radiographic Findings
  • Cotton ball appearance of the skull during
    reparative phase and sharply demarcated
    radiolucency during the destructive phase.

19
Benign Bone Tumors
  • Bone Cyst
  • A wall of fibrous tissue filled with clear fluid
  • Radiographic Findings
  • Not demonstrated unless a pathological fracture
    occurs.

20
Benign Bone Tumors
  • Osteochondroma (exostosis)
  • Arises from the cortex and grows parallel to the
    bone
  • Radiographic Findings
  • Usually contains a cartilaginous cap with
    flake-like calcifications in it.

21
Benign Bone Tumors
  • Endochondroma
  • Most often found in the hands and feet
  • Radiographic Findings
  • A well demarcated tumor which causes thinning and
    scalloping of the cortex

22
Benign Bone Tumors
  • Giant Cell Tumor (osteoclastomas)
  • Most common in long bones of young people in
    their early 20s
  • Radiographic Findings
  • It appears as large bubbles separated by thin
    strips of bone, likened to a mass of soap
    bubbles

23
Benign Bone Tumors
  • Osteoid Osteoma
  • Tumor usually found in the femur or tibia.
  • Classic symptom is pain that is markedly worse a
    night but is relieved by Aspirin
  • Radiographic Findings
  • An area of dense bone surrounding a radiolucent
    area of cartilage (nidus)
  • Most commonly shown on tomography

24
Malignant Bone Tumors
  • Chondrosarcoma
  • Malignant tumor of the cartilage
  • Radiographic Findings
  • Appears as a radiolucent area

25
Malignant Bone Tumors
  • Osteogenic sarcoma (osteosarcoma)
  • Highly malignant
  • Occurs in long bones
  • Radiographic Findings
  • Characteristic sunray appearance from mixed
    areas of radiolucent and dense areas

26
Malignant Bone Tumors
  • Ewing sarcoma
  • Shows up primarily in children 5-15.
  • Occurs in the diaphysis of long bones
  • Radiographic Findings
  • Bones have a stratified new bone formation
    causing the onion peel appearance

27
Malignant Bone Tumors
  • Multiple Myeloma
  • Multiple lesions in various areas of the body,
    particularly the flat bones
  • Radiographic Findings
  • Punched out osteolytic lesions, not unlike a
    Swiss cheese effect.

28
Malignant Bone Changes
  • Multiple Myeloma
  • Swiss Cheese Appearance

29
Bone Metastases
  • The most common malignant bone tumor spreading by
    means of the blood stram or lymphatic vessels or
    by direct extension.
  • Radiographic Findings
  • A broad spectrum of radiographic appearances is
    apparent due to the extent of the disease

30
Joint Pathology
  • Arthritis
  • An inflammation of the joint

31
Types of Arthritis
  • Rheumatoid arthritis
  • Starts as an inflammation of the synovial
    membrane which leads to a thickened tissue that
    grows inward and damages the cartilage
  • Radiographic findings
  • Soft tissue swelling around the joints in the
    early stages
  • Decrease in joint space with eroded bone ends and
    subluxation in later stages
  • Boutonniere deformity or abnormal flexion
    occurs in advanced stages
  • Swan neck deformity an abnormal hyper
    extension occurs in advanced stages

32
Arthritis
  • Osteoarthritis
  • Rheumatoid arthritis

33
Arthritis
  • Gout
  • Tophus

34
Types of Rheumatoid Arthritis
  • Ankylosing Spondylitis or Rheumatoid Spondylitis
  • Affects mainly the SI joins as well as the spine
  • Radiographic Findings
  • Fusing of the SI joints and Spine which is termed
    bamboo spine

35
Types of Rheumatoid Arthritis
  • Reiter Syndrome
  • Effects mainly the lower extremities.
  • Other complications include ulceration of the
    hands and soles of the feet
  • Radiographic Findings
  • Similar to classic rheumatoid arthritis

36
Types of Rheumatoid Arthritis
  • Psoriatic arthritis
  • Rheumatoid like destructive process involving the
    distal joints rather that the proximal joints.
  • Radiographic Findings
  • Classis pencil-like destruction of the joint
    spaces

37
Types of Arthritis
  • Osteoarthritis (Degenerative Joint Disease)
  • Non inflammatory deterioration of the articular
    cartilage with new bone forming at the surface of
    the joint
  • Also called degenerative joint disease and
    hypertrophic arthritis
  • Radiographic Findings
  • sprruing
  • Mild subluxation
  • Loose bodies within the joint space
  • Narrowed joint spaces

38
Common Pathology that Accompanies Arthritis
  • Bursitis
  • An inflammation of the synovial bursa caused by
    excess stress on the joint
  • Spondylolisthesis
  • Forward displacement of the vertebra on top of
    another
  • Usually at the L5 - S1 junction

39
Common Pathology that Accompanies Arthritis
  • Osteomyelitis
  • An inflammation of the bone marrow caused by
    infections organisms that reach bone by
    Hematogenous spread
  • Radiographic Findings
  • Starts with the displacement of normal fat pads
    and progresses to a ragged,, moth-eaten
    appearance of the bone.

40
Fractures
  • A discontinuity of bone caused by force applied
    either directly or indirectly to the bone

41
Types of Fractures
  • Complete
  • A fracture through the entire bone
  • Incomplete
  • Fracture of only the cortex
  • Closed
  • If the skin is not broken and a bone is broken

42
Types of Fractures
  • Open or compound
  • The skin must be pierced by at least one end of
    the fractured bone
  • Simple
  • Divides the bone into two complete pieces
  • Comminuted
  • The bone is shattered into many pieces (3 or more)

43
Common Fractures
  • Transverse Tours
  • Oblique Longitudinal
  • Spiral Compression
  • Comminuted Impacted
  • Avulsion Pathologic
  • Butterfly
  • Segmental
  • Greenstick
  • Fatigue, march fracture or stress fracture

44
Fracture Healing
  • Malunion
  • Healing of fragments of a fracture in a faulty
    position
  • Delayed union
  • Any fracture that takes longer to heal than the
    average fracture at that anatomic location
  • Non-union
  • The fracture healing process has completely
    stopped and the fragments will remain un-united
    even with prolonged immobilization

45
Fracture Healing
  • Pathological fractures
  • Fractures occurring in the bone that has been
    weakened by a preexisting condition
  • Stress fractures (fatigue fractures)
  • Results of repeated stresses to a bone that would
    not be injured by isolated forces of the same
    magnitude
  • Battered child syndrome
  • Multiple repeated physically induced injuries in
    young children caused by parents or guardians

46
Special Fractures
  • Jefferson fracture
  • Comminuted fracture of the ring of the atlas that
    involves both the anterior and posterior arches
    and causes displacement of the fragments
  • Hangmans fracture
  • The result of acute hyper extension of the head
    on the neck

47
Special Fractures
  • Clay shovelers fracture
  • An avulsion fracture of a spinous process in the
    lower cervical or upper thoracic spine
  • Seat belt fracture
  • Transverse fracture of a lumbar vertebra that is
    often associated with significant visceral
    injuries.

48
Special Fractures
  • Colles fracture
  • The distal radius fractures with the fragment
    being displaced posteriorly
  • Smith fracture
  • Forward displacement of the fragment of the
    distal radius

49
Special Fractures
  • Potts Fracture
  • A fracture that involves both malleoli with a
    dislocation of the ankle joint.

50
Common Pathologies of the Spine
  • Spondylitis
  • Inflammation of the spinal vertebrae
  • Spondylosis
  • Condition of the spine characterized by fixation
    and stiffness
  • Disk herniation
  • The fibrous ring of the disk degenerates to the
    point that the pulpy nucleus is forced out

51
THE END
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