Term
| what is the difference between synarthoses and diarthroses? |
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Definition
| diarthroses (or caviated joints) can freely move while syn (or solid joints) have limited motion |
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Term
| varieties of synarthroses |
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Definition
- syndesmoses - fibrous - ligaments, teeth
- synchondroses - cartilage - physeal of growing bone
- synphases - fibrocartilage - public symphasis, interverterbral disc
- synostoses - bones
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Term
| architecture of a synovial joint: |
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Definition
- bones are linked by a fibrous capsule
- accessory ligaments (stabilize joint by limiting motion; can be intra- or extra-capsular)
- articular disc or menisci (i.e. medial and lateral to knee)
- muscles and tendons (i.e. rotator cuff muscles)
- fluid
- originate embryologically from mesencyme called skeltal blastema
- lubrican is the proteoglycan which accounts for smoothness of joint surfaces
- hyaluronic acid accounts of viscocity of fluid
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Term
| features of articular cartilage: |
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Definition
•Wear-resistant
•Low-friction
•Lubricated surface
•Slightly compressible
•Elastic
•Absorb large forces of compression and shear
•Ideal for easy movement over similar surface |
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Term
| synovial tissue covers the bone and cartilagenous surface and joint cavity (T/F?) |
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Definition
FLASE, OMG FALSE!!!
the synovial tissue covers the bone and joint cavity but NOT the carliage |
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Term
| synoviocyte characteristics? |
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Definition
they are intimal cells
type A: large golgi, many filopodia, vacuoles, mitochondria, monocyte/macrophage lineage, phagocytic
type B: granular ER, fewer vacuoles, fibroblast (mesenchymal) lineage, secretory |
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Term
| needs of a synovial joint: |
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Definition
lots of blood flow to allow for solute and gas exchange
blood flow also regulates temperature
if the joint doesn't move, exchange slows down, blood flow is impeded by swelling |
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Term
| how do you know if pathology is present involving a synovial joint? |
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Definition
the fluid should be clear with no crystals
cloudy means cellular or infected
if there is any pelleting, it should be one continous pellet, not broken up and floating |
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Term
MRI Terms
TE, TR, T1, T2? |
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Definition
TE= time to echo, excitation to energy release
TR= time to repetition
T1= gain time for magnetism
T2= loss of magnetism time, decay |
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Term
| differences between T1 and T2 magnetism in MRI? |
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Definition
T1 give best anatomic structure, watery and thin substances are dark in T1 and bright in T2
fat is bright in T1 |
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Term
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Definition
| bone collapses in on self |
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Term
| how is an avulsion fracture caused? |
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Definition
| by distractive forces at sites of muscle, tendon, or ligmanet attachments to bone |
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Term
| what is a comminuted fracture? |
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Definition
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Term
| what might a sclerotic rim around a bone tumor signify? |
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Definition
that it is a benign tumor (95% of time) which is giving the bone enough time to try and contain it and grow new bone
often seen in weight bearing bones |
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Term
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Definition
there is no scleroitc rim but the boundries of the tumor are still well circumscribed
the tumor does begin to distort the shape of the bone and reaches the periosteum. if it breaks out it can cover bone
likely a low grade tumor |
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Term
| presentation of high-grade bone tumors and osteomyelitis |
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Definition
moth eaten appearance with many radioluciencies seen along affected area
involves medullary and coritcal bone |
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Term
| what is a codman's triangle? |
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Definition
the markings of a malignant tumor where the lamellated (onion like) protusions on the periosteum have broken and leave acute looking angles
also seen in reactive osteomyelitis |
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Term
| what is the appearance of a bone tumor that is cartilagenous in nature? |
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Definition
| a popcorn like appearance |
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Term
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Definition
AD
mutation in FGFR3 inhibiting chondrocyte proliferation
effects endochondral ossification only …short limbs and relatively large head and torso |
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Term
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Definition
•I : AD, fractures, blue sclera (due to choroid showing through), hearing loss, better after puberty
•II : AR, still born or death after birth ( crushed)
•III : AD or AR, fractures and skeletal deformities, dental defects, hearing loss, blue sclera
•IV : AD, varying severity, fractures, white sclera, teeth are OK
•? Confuse with child abuse?
•
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Term
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Definition
•Marble Bone Disease, Albers-Schönberg Disease
•Failure of osteoclastic bone resorption leads to loss of medullary cavity, loss of marrow function, loss of bone remodeling
•Thick, dense brittle bone (chalk-like)
•Anemia, bone deformity broad metaphyses (Erlenmeyer flask)
Limited RANKL
Carbonic Annydrase II enzyme deficiency |
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Term
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Definition
OSTEITIS DEFORMANS
There is bone reabsorption but rebuilding is erractic and disorganized
high alkaline phosphatase
thick bone, thick skull, femur, vertebrae
abnormal arteriole and venous connections
mosaic pattern
deafness
osteosarcoma |
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Term
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Definition
rickets in kids
both are vitamin D deficiencies nad cause weak bones that bow
renal and liver disease are associated |
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Term
| symptoms of fibrous dysplasia |
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Definition
cafe au lait spots
replacement of marrow by fibrous tissue
may be associated with preccocious puberty in girls
McCune-Albright syndrome |
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Term
| what causes pyogenic osteomyelitis and who is suseptible? |
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Definition
staph aureus
people with urinary tract infections, infants with the flu, drug addicts
(possible caused by salmonella in patients with sickle cell) |
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Term
| involucrum and sequestrum? |
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Definition
involucrum is the formation of new bone around necrotic bone
sequestrum is dead or necrotic bone surrounded by pus |
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Term
| where do skeletal tumors come from? |
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Definition
they are almost always metastases from primary tumors, 75% are from prostate, breast, kidney, and lung carcinomas
IF they are primary, you'll find them in the distal femur or prox tibia
high grade sarcomas will usually arise from damaged bone (osteomyelitis, paget's disease) |
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Term
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Definition
almost always seen in persons 20-50, almost never seen in people 60+ or children
locally agressive but rarely metastasizes |
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Term
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Definition
| multiple osteomas of mandible and maxilla |
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Term
| ostiod osteoma vs. osteoblastoma |
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Definition
histologically identical, both occur in young people, both are painful
osteoblastoma is larger
ostiod ostooma can be relieved by pain (bc pain is derived from prostoglandin production), osteoblastoma cannot |
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Term
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Definition
| usually occur in patients <20 yo, include neuroblastoma, wilms, ewings sarcoma, malignant mesencymal tumors, often have lung mets |
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Term
| Exostosis (osteochondroma) |
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Definition
Benign cartilage-capped (hyaline) outgrowth attached to underling skeleton by bony stalk.
can be hereditary, AD
Maffucci syndrome is many enchondromas (arise from medullary cavity)
-picture of hand with 100 small tumors
chondroSARCOMAs are malignant
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Term
Fibrous Cortical Defect/ Nonossifying Fibroma
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Definition
•FCDs are very common in children > 2 year, Most are in the distal femur or proximal tibia;
•Asymptomatic; incidental finding, usually undergo spontaneous resolution and are replaced by normal cortical bone. If progression to NOF, may present with pathological fracture requiring biopsy and curettage
is a NOF, pinwheel shaped cell formations occur and the histocytes are multinucleated giant cells
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Term
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Definition
primative neuroectodermal tumor (PNET) of children and young adults
invades cortex and periosteum
t(11;22) EWS-FLI1 which acts as a dominant oncogene
very crowded large nuclei upon microscopic review |
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Term
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Definition
erosion of articular cartilage; Aging “wear and tear” and genetics contribute to primary osteoarthritis development.
The hyaline cartilage consists of Type II collagen and proteoglycans,both secreted by chondrocytes,
Chondrocytes synthesize the matrix and secrete matrix-degrading enzymes in the process of “turnover”.
•Usually patients have deep, achy pain which worsens with use, morning stiffness, crepitus, limitation of range of motion; if osteophytes impinge on nerves, radicular pain and muscle spasm may occur
•Commonly involved joints: hip, knees, lower lumbar and cervical vertebrae, fingers.
•Heberden nodes = in DIP
Boucher's nodes = in PIP
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Term
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Definition
autouimmune disease, affects joints, has synovitis and leads to spurs, cysts, assymetry, eburnation (polished ivory with exposed subchondral layer)=halmarks of R.A.
can show serum RF (rheumatoid factor)
CD4+ T-cells get activated and release cytokines in joints which causes the immune response
-ie. TNF and IL-1 cause synovial cells to produce inflammatory mediators like prostoglandins and metalloproteinases
rheumatoid nodules on skin can also form |
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Term
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Definition
| erosive synovium, it is made up of inflammatory cells, granulation tissue, and fibroblasts. this actually grows OVER cartilage and starts eroding it |
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Term
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Definition
•Caused by spirochete Borreliaburgdorferi
•60 to 80% of untreated pts develop joint symptoms within few weeks to 2 yrs from onset of disease
•Arthritis is remitting and migratory, affecting large joints, esp. knees, shoulders, elbows, ankles
•Chronic papillary synovitis with synoviocyte hyperplasia, fibrin deposition, lymphocyte infiltration, and onionskin thickening of vessel walls
•Need serology for diagnosis; may mimic RA |
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Term
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Definition
Gout = inflammatory arthritis produced in response to the deposition of sodium urate crystals in the periarticular tissues; end result of hyperuricemia..
Most patients also develop urate nephropathy – renal disorder associated with deposition of monosodium urate crystals in renal medullary insterstitium – may form uric acid stones. 20% of pts with chronic gout die of renal failure..
can be caused by overproduction of uric acid, or normal production with under excretion
crystals are chemotaxic and activate complement, therefore, they cause an immune response. neutrophils and macrophages accumulate
joints appear chalky upon gross inspection (tophi deposits)
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