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Diseases, disorders, and injuries of the Skeletal system

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A number of diseases can affect bone, including arthritis, fractures, infections, osteoporosis and tumours. Conditions relating to bone can be managed by a variety of doctors, including rheumatologists for joints, and orthopedic surgeons, who may conduct surgery to fix broken bones.

Other doctors, such as rehabilitation specialists may be involved in recovery, radiologists in interpreting the findings on imaging, and pathologists in investigating the cause of the disease, and family doctors may play a role in preventing complications of bone disease such as osteoporosis.

When a doctor sees a patient, a history and exam will be taken. Bones are then often imaged, called radiography. This might include ultrasound X-ray, CT scan, MRI scan and other imaging such as a Bone scan, which may be used to investigate cancer.[32] Other tests such as a blood test for autoimmune markers may be taken, or a synovial fluid aspirate may be taken. Bone density. Bone density (or bone mineral density) is a medical term normally referring to the amount of mineral matter per square centimeter of bones.[1] Bone density (or BMD) is used in clinical medicine as an indirect indicator of osteoporosis and fracture risk.

Bone density

This medical bone density is not the true physical "density" of the bone, which would be computed as mass per volume. It is measured by a procedure called densitometry, often performed in the radiology or nuclear medicine departments of hospitals or clinics. The measurement is painless and non-invasive and involves low radiation exposure. Measurements are most commonly made over the lumbar spine and over the upper part of the hip.[2] The forearm may be scanned if the hip and lumbar spine are not accessible.

Artificial bone. Flexible hydrogel-HA composite, which has a mineral-to-organic matrix ratio approximating that of human bone.

Artificial bone

Artificial bone refers to bone-like material created in a laboratory that can be used in bone grafts, to replace human bone that was lost due to severe fractures, disease, etc.[1] Overview[edit] Bones are rigid organs that serve various functions in the human body (or generally in vertebrates), including mechanical support, protection of soft organs, blood production (from bone marrow), etc. Bone disease. Bone fracture. A bone fracture (sometimes abbreviated FRX or Fx, Fx, or #) is a medical condition in which there is a break in the continuity of the bone.

Bone fracture

A bone fracture can be the result of high force impact or stress, or a minimal trauma injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture.[1] Although broken bone and bone break are common colloquialisms for a bone fracture, break is not a formal orthopedic term. Signs and symptoms[edit] Although bone tissue itself contains no nociceptors, bone fracture is painful for several reasons:[2] Breaking in the continuity of the periosteum, with or without similar discontinuity in endosteum, as both contain multiple nociceptors.Edema of nearby soft tissues caused by bleeding of torn periosteal blood vessels evokes pressure pain.Muscle spasms trying to hold bone fragments in place.

Bone tumor. A bone tumor, (also spelled bone tumour), is a neoplastic growth of tissue in bone.

Bone tumor

Abnormal growths found in the bone can be either benign (noncancerous) or malignant (cancerous). A bone lytic lesion (often just lytic lesion) is an area where part of a bone appears to have been dissolved or "eaten away". Average five year survival in the United States after being diagnosed with bone and joint cancer is 67%.[1] Bone metastasis. Sclerotic breast cancer metastases in the pelvis.

Bone metastasis

Osteomyelitis. Osteomyelitis (sometimes abbreviated to OM, and derived from Greek words osteon, meaning bone, myelo- meaning marrow, and -itis meaning inflammation) is infection and inflammation of the bone or bone marrow.[1] It can be usefully subclassified on the basis of the causative organism (pyogenic bacteria or mycobacteria) and the route, duration and anatomic location of the infection.


Classification[edit] The definition of OM is broad, and encompasses a wide variety of conditions. Traditionally, the length of time the infection has been present and whether there is suppuration (pus formation) or sclerosis (increased density of bone) is used to arbitrarily classify OM. Chronic OM is often defined as OM that has been present for more than one month. In reality, there are no distinct subtypes, instead there is a spectrum of pathologic features that reflect balance between the type and severity of the cause of the inflammation, the immune system and local and systemic predisposing factors.

Osteogenesis imperfecta. Osteogenesis imperfecta (OI and also known as brittle bone disease, or "Lobstein syndrome"[1]) is a congenital bone disorder characterized by brittle bones that are prone to fracture.

Osteogenesis imperfecta

People with OI are born with defective connective tissue, or without the ability to make it, usually because of a deficiency of Type-I collagen.[2] Eight types of OI can be distinguished. Most cases are caused by mutations in the COL1A1 and COL1A2 genes. Diagnosis of OI is based on the clinical features and may be confirmed by collagen or DNA testing. There is no cure for OI. Treatment is aimed at increasing overall bone strength to prevent fracture and maintain mobility. Types[edit] Of the eight different types of OI, Type I is the most common, though the symptoms vary from person to person. Type I[edit] Blue sclera in osteogenesis imperfecta. Osteochondritis dissecans. Osteochondritis dissecans /ˌɒsti.oʊkɒnˈdraɪtɪs ˈdɪsɨkænz/, often abbreviated to OCD or OD, is a joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone.[1] OCD is caused by blood deprivation in the subchondral bone.

Osteochondritis dissecans

This loss of blood flow causes the subchondral bone to die in a process called avascular necrosis. The bone is then reabsorbed by the body, leaving the articular cartilage it supported prone to damage. The result is fragmentation (dissection) of both cartilage and bone, and the free movement of these osteochondral fragments within the joint space, causing pain and further damage.[2][3][4] OCD also is found in animals, and is of particular concern in horses, as there may be a hereditary component in some horse breeds.[8] Feeding for forced growth and selective breeding for increased size are also factors. Classification[edit] OCD is classified by the progression of the disease in stages.

Arthritis. Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a form of joint disorder that involves inflammation of one or more joints.[1][2] There are over 100 different forms of arthritis.[3][4] The most common form, osteoarthritis (degenerative joint disease), is a result of trauma to the joint, infection of the joint, or age.


Other arthritis forms are rheumatoid arthritis, psoriatic arthritis, and related autoimmune diseases. Septic arthritis is caused by joint infection. Classification[edit] There are several diseases where joint pain is primary, and is considered the main feature. Generally when a person has "arthritis" it means that they have one of these diseases, which include: Ankylosing spondylitis. Ankylosing spondylitis (AS, from Greek ankylos, crooked; spondylos, vertebra; -itis, inflammation), previously known as Bechterew's disease (or syndrome) and Marie-Strümpell disease, is a chronic inflammatory disease of the axial skeleton, with variable involvement of peripheral joints and nonarticular structures.

Ankylosing spondylitis

AS is a member of the group of the spondyloarthropathies,[1] with a strong genetic predisposition.[1] It mainly affects joints in the spine and the sacroiliac joint in the pelvis. In severe cases, it can eventually cause complete fusion and rigidity of the spine.[2] "Bamboo spine" develops when the outer fibers of the fibrous ring of the intervertebral disks ossify, which results in the formation of marginal syndesmophytes between adjoining vertebrae. It usually begins in the second or third decade of life and tends to occur more often in males. Skeletal fluorosis. Skeletal fluorosis is a bone disease caused by excessive accumulation of fluoride in the bones. In advanced cases, skeletal fluorosis causes pain and damage to bones and joints.

Causes[edit] Common causes of fluorosis include inhalation of fluoride dusts/fumes by workers in industry, use of coal as an indoor fuel source (a common practice in China), consumption of fluoride from drinking water (naturally occurring levels of fluoride in excess of the CDC-recommended safe levels[1]), and consumption of fluoride from drinking tea,[2] particularly brick tea. Skeletal fluorosis can be caused by cryolite (Na3AlF6, sodium hexafluoroaluminate), and the disease was first recognized among workers processing cryolite.[3] In India, the most common cause of fluorosis is fluoride-laden water derived from deep-bore wells.