fatima's soft bones

Causes of bone pain
1. Osteoporosis
2. Bone tumor
3. Bone infection (osteomyelitis)
4. Hypercalcemia
5. Rickets and osteomalacia
6. Paget disease of the bone
OSTEOPOROSIS
1. Types of osteoporosis
  1. Localized osteoporosis:
    1. e.g. disuse osteoporosis in a limb.
  2. Generalized osteoporosis:
    1. secondary
      1. Due to: -Endocrine disorder: Hyperparathyroidism -Neoplastic: Multiple metastatic carcinoma. -Gastrointestinal:
    2. Primary(Commonest Type)
      1. Senile form: affects elderly people of both sexes
      2. Postmenopausal form: It occurs in post menopausal women
2. Morphology
  1. whole skeleton is affected cortex and trabeulae are thinned haversian systems widened normal composition
3. Pathogenesis
  1. Decrease in total bone mass and density.
4. Risk factors
5. Type 2 diabetes and osteoporosis
  1. previously believed to provide bone protection because of its associated normal to increased BMD. When considering all of the risk factors , patients with diabetes generally have an increased risk of falling because of peripheral neuropathy, possible hypoglycemia, and visual impairment.
6. Investigations
  1. Complete Blood Count
  2. Electrolyte test
  3. Blood Sugar Test
  4. Thyroid Hormone Test
  5. Screening Test
    1. Bone Mineral Density FRAX tool- Ultrasound
7. Management of Osteoporosis
  1. Pharmacological treatment
    1. Bisphosphonates
    2. Selective estrogen receptor modulators
    3. Calcitonin
    4. Denosumab
    5. Teriparatide
  2. non-pharmacological
    1. Nutrition therapy
      1. CALCIUM
      2. Vitamin D
  3. hormone Replacement Therapy
    1. increase bone density reduce the rate of fracture useful for women who have undergone early menopause (before 45 years of age) increased the risk of heart disease and stroke
  4. Physiotherapy
    1. Help strengthen your bones & muscles. Prevent bone thinning Improve your balance>reduce falls
8. Most common Fractures
  1. Vertebral Fractures
  2. Non-vertebral Fractures(Hip , wrist , Arm )
    1. Hip Fracture
      1. possible complications after a hip fracture
        Blood clots Pneumonia Post-operative infection
9. definition
  1. A term denoting increased porosity of the skeleton and increased bone fragility due to reduction in bone mass.
11. Quality of life
  1. 1. Impaired physical ability
  2. 2. Reduced social activity
  3. 3. Poor well being
  4. 4. Depressed mood
Physical Examination of the Hip
1. inspection: Position (deformity) : the hip may show : flexion deformity adduction deformity abduction deformity rotation (internal or external)
2. palpation: Palpate for the temperature around the joint Palpate the bony contour & muscles. Using the thumb & index fingers, bilaterally palpate the relation between ASIS and (Palpation) the greater trochanters & compare either sides. During palpation you look for any tenderness, Swellings, or Atrophy.
3. movement: Both active & passive movements are tested for ROM
4. Special tests:
  1. Thomas’ test :
  2. Trendelenburg test:
Treatment of Hip Bone Fracture
1. Arthroplasty
  1. In this surgical procedure, a joint can be restored by resurfacing the bones or replacing all or parts of the hip joint with a man-made joint. This artificial joint is called a prosthesis .
anatomy
1. hip bone
2. femour
3. Ligaments of Hip Bone
4. Blood Supply to the head and neck of femur
5. Femoral Triangle Region
6. Gluteal Region

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fatima's soft bones

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	Created by sarah hammoodi almost 8 years ago