(c, d) Radiographs of the left femoral neck (c) and left proximal humerus (d) show that the same patient also fractured his left femoral neck (arrow on c) and left proximal humerus (circle on d). (a, b) Posteroanterior (a) and lateral (b) radiographs of the left wrist show a comminuted, impacted, dorsally angulated intra-articular fracture (arrow) of the distal radius, acquired positive ulnar variance, and an ulnar styloid fracture (circle on a). Distal radius fracture in an 81-year-old man with a history of prostate cancer, chronic renal insufficiency, and osteoporosis who fell at a restaurant. Severe osteoporosis may prevent detection of nondisplaced fractures, and CT or magnetic resonance (MR) imaging may be helpful for diagnosis if the patient has severe pain and a normal radiograph.įigure 1a. The three most common fracture locations are the forearm, the hip, and the spine ( Fig 1) ( 10). One-third of women older than 50 years and one-fifth of men older than 50 years will have an osteoporotic fracture ( 7– 9). Worldwide, one osteoporotic fracture occurs almost every 3 seconds, which results in 9 million fractures each year ( 6). Osteoporosis results in substantial morbidity and mortality, primarily through fractures. With the development of quantitative computed tomography (CT), dual-energy photon absorptiometry, and, later, dual-energy x-ray absorptiometry, reliable measurement methods became available, leading to a change in the definition. In the years prior to reliable quantification of bone mass, a patient was considered to have osteoporosis only when a nontraumatic fracture had occurred. Osteoporosis is the most common metabolic bone disease, affecting 13%–18% of women older than 50 years and 1%–4% of men older than 50 years ( 2– 5). Vitamin C deficiency, or scurvy, impairs posttranslational collagen modification, leading to subperiosteal hemorrhage and fractures. The findings of acromegaly are due to excess growth hormone secretion and therefore proliferation of the bones and soft tissues. Soft-tissue proliferation of thyroid acropachy is most often observed in the hands and feet. Thyroid hormone regulates endochondral bone formation and congenital hypothyroidism, when untreated, leads to delayed bone age and absent, irregular, or fragmented distal femoral and proximal tibial epiphyses. Renal osteodystrophy is the collection of skeletal findings observed in patients with chronic renal failure and associated secondary hyperparathyroidism and can include osteopenia, osteosclerosis, and “rugger jersey spine.” Hypoparathyroidism is most commonly due to iatrogenic injury, and radiographic findings of hypoparathyroidism reflect an overall increase in bone mass. ![]() Findings of hyperparathyroidism are the result of bone resorption, most often manifesting as subperiosteal resorption in the hand. Hypophosphatasia is a congenital condition of impaired bone mineralization with wide phenotypic variability. Osteomalacia is the result of impaired mineralization of newly formed osteoid, which leads to characteristic Looser zones. Impaired chondrocyte development and failure to mineralize growth plate cartilage in rickets lead to widened growth plates and frayed metaphyses at sites of greatest growth. ![]() Osteoporosis, the most common metabolic bone disease, results in generalized loss of bone mass and deterioration in the bone microarchitecture. ![]() Metabolic bone diseases are a diverse group of diseases that result in abnormalities of (a) bone mass, (b) structure mineral homeostasis, (c) bone turnover, or (d) growth.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |