BONE DISEASES

BONE
one of the hardest tissues of body Ch. Ch. By high elasticity

Bone is a calcified collagenous matrix with some cells entrapped in-between

3
3- Bundle bone

TYPES OF BONE
types have been recognized

1- Lamellar bone = Mature bone

2- NON-Lamellar bone = Immature bone = WOVEN BONE

Classification of bone diseases

BONE

Hyperparathyrodism
= Osteitis Fibrosa Cystica = Von Recklinghausen's disease of bone

= PTH

In 2ry hyperparathyroidism, high levels of PTH do not cause hypocalcaemia

2 Types (1ry, 2ry hyperparathyroidism) are harmful to bone????!!!

Clinical features

BONE

Fibrous Dysplasia of of bone bone

Bone is replaced by Fibrous C.T proliferating

gritty
Ossous metaplasia Woven Bone

Bone resorption

Fibrous replacement

Fibrous Dysplasia of bone

Etiology ??!!
1. Non- Neoplastic growth 2. Abnormal reaction to traumatic episode. 3. Endocrinal disturbances.

TYPES

Monostotic Fibrous Dysplasia

= fibrous dysplasia confined to a single bone, 6 times as polyostotic Age Sex Site 1st or 2nd decade of life (4-18 years) = affects only one bone particularly the jaws. Max. > Mand. Slowly growing painless swelling. not well circumscribed (diffuse) smooth and covered e normal mucosa. Disfiguring stabilization and expansion stops with skeletal maturation.

S&S

Age Sex Site

S&S

1st or 2nd decade of life (4-18 years) = affects only one bone particularly the jaws. Max. > Mand. Slowly growing painless swelling. not well circumscribed (diffuse) smooth and covered e normal mucosa. Disfiguring stabilization and expansion stops with skeletal maturation.

Polystotic Fibrous Dysplasia

= fibrous dysplasia involve multiple bones, up to 75% of skeleton Age 1st or 2nd decade Albrights syndrome Jaffe 'sSex syndrome > Site involves several bones including long bones, skull and jaws. Polystotic fibrous Slowly dysplaisa growing painless swelling. Polystotic fibrous dysplaisa not well circumscribed (diffuse) Caf au lait skinsmooth and covered e normal mucosa. S&S Caf au lait skin pigmentation Disfiguring pigmentation stabilization and expansion stops with skeletal maturation.
Endocrinal disturbances

Oral manifestation

Radiographic features
Lesions merge with normal bone at the margins (= ill defined)

Lesion differ radiographoically according degree of osseous metaplasia 1. Mottled or Mixed 2. Radio-opaque.

Histopathological features

Treatment
Self limiting Cosmotic surgery may be needed

BONE

Pagets disease of bone

Etiology ??!! Phases
2nd most common osteodystrophic condition after osteopetrosis

1. Inflammatory disease (Paget's original believe). 2. Autoimmune disease. 3. Endocrine abnormality related to hyperthyroid disease. 4. vascular disorder. 5. Bone remodling disturbance. 6. viral infection (paramyxo v. + measles + RSV)

Clinical features
Age Sex
uncommon before age 40 (= 40 years) > (2:1) vertebral column (1st most common site) - Sacrum > Lumbar > Thoracic > Cervical vertebrae. - mechanical stress i.e bearing most wt. being most affected Skull (next most frequently affected) - mand. & max. about 17% of cases. - Max.> Mand. - functional stress + traction of neck muscles + stresses of mastication

Site

severe pain. Bones become larger. S&S

flat bones become thicker. round bones in circumference hats and dentures may no longer fit.

Weight bearing bones

bend under pressure crippling + bowing deformities.

break easily.

Deafness and Blindness , d.t. narrowing of cranial foramina. High cardiac output failure may occur due to arteriovenous shunt.

Clinical features

Clinical features

Clinical features

Clinical features

Clinical features

Radiographical features

Histopathological features

BONE
A) Affects membranous bone Cleido-cranial dysplasia B) Affects endochondral bone achondroplasia C) Affects both types of bone OI , cherubism , osteopetrosis

= familial fibrous dysplasia = familial multilocular cystic disease of jaws

Cherubism

Pathogenesis

Clinical features
Age Sex Site S&S early childhood bn (2-4 years) > Mand.> Max. Bilateral ,Firm, painless swelling at angles of mand.

Cleidocranial dysostosis
Clavicle complete or SKULL partial aplasia defect in suturesof ossification = clavicle dysplasiaand = abnormal = abnormal development skull development

Clavicle complete or partial aplasia SKULL defect in sutures ossification

Osteogenesis imperfecta