C. Infection of the Bone 2222222

• Osteomyelitis


  Severe infection of the bone, bone marrow, and surrounding soft tissue

  
• Osteomyelitis


  • Staphylococcus aureus is a common cause
  • Pelvis, tibia, and vertebrae are the most common sites of infection
• Part of periosteum with blood supply forms new bone called involucrum

  
• Acute osteomyelitis


  Infection of less than 1 month in duration
• Chronic osteomyelitis


  Bone infection more than 1 month or an infection that has failed to respond to initial course of antibiotic therapy

  
• Benign bone tumors


  More common than primary malignant tumors

  
• Main types of benign bone tumors

  • Osteochondroma
  • Osteoclastoma
  • Endochroma

  
• Osteochondroma


  Overgrowth of cartilage and bone near the end of the bone at the growth plate, commonly found in long bones of leg, pelvis, or scapula

  
• Treatment of asymptomatic osteochondroma

  No treatment necessary

  
• Treatment of symptomatic osteochondroma

  Surgical resection

  
• Malignant bone tumors

  Sarcoma, a malignant tumor that can develop in bone, muscle, fat, nerve, or cartilage

  
• Osteosarcoma


  Most common malignant bone tumor, usually occurs in the metaphyseal region of the long bones of extremities, often associated with Paget's disease and prior radiation

  
• Metastatic bone cancer


  Metastatic cancer cells travel from the primary tumor to the bone via lymph and blood supply, commonly found in vertebrae, pelvis, femur, humerus, or ribs

  
• Treatment of metastatic bone cancer

  • Palliative treatment with radiation and pain management
  • Surgical stabilization of the bone

  
• Muscular dystrophy


  Group of genetic diseases characterized by progressive symmetric wasting of skeletal muscles without neurologic involvement, most common type is Duchenne

  
• Duchenne and Becker muscular dystrophy


  1. linked recessive disorders with mutation in the dystrophin gene, leading to defects in the plasma membrane of muscle fibers
• Diagnosis of muscular dystrophy

  Muscle biopsy

  
• Osteomalacia


  Caused by vitamin D deficiency, resulting in decalcification and softening of bones

  
• Diagnostic finding in osteomalacia

  Looser's transformation zones (ribbons of decalcification in bone found on x-ray)
• Osteoporosis


  Chronic, progressive metabolic bone disease characterized by low bone mass and structural deterioration, leading to increased bone fragility

  
• Paget's disease


  Chronic skeletal disorder characterized by abnormal bone remodeling

  
• Osteomalacia


  Vitamin D deficiency
• Osteoporosis


  Porous bone (fragile bone disease), a chronic, progressive metabolic bone disease characterized by low bone mass and structural deterioration of bone tissue, leading to increased bone fragility

  
• Osteoporosis

  • Back pain or spontaneous fractures, gradual loss of height and a humped back known as kyphosis or "dowager's hump"
• Nursing and Collaborative management of osteoporosis1. Teach patient the importance of taking supplemental calcium

  2. Supplemental vitamin D (800 to 1000 IU) is recommended for postmenopausal women, older men, and those who get minimal sun exposure
• Paget's disease


  A chronic skeletal bone disorder in which excessive bone resorption is followed by replacement of normal marrow by vascular, fibrous connective tissue. The new bone is larger, disorganized and structurally weaker.
• Radicular pain


  Caused by irritation of a nerve root. Sciatica is an example of radicular pain.
• Referred pain


  Felt or perceived in the lower back, but the source of the pain is another location (e.g., kidneys, lower abdomen)
• Acute low back pain


  Lasts 4 weeks or less, mostly caused by trauma or some type of activity that causes undue stress (often hyperflexion) of the lower back
• Chronic low back pain


  Low back pain that lasts more than 3 months or is a repeated incapacitating episode
• Spinal stenosis


  A narrowing of the spinal canal (hollow vertical hole that contains the spinal cord) due to arthritic changes (bone spurs, calcification of spinal ligaments, degeneration of disc), leading to compression
• Intervertebral disc disease


  A condition that involves the deterioration, herniation, or other dysfunction of the intervertebral discs

  
• Herniated disc (slipped disc)


  A condition in which a spinal disc herniates and bulges outward between the vertebrae. The most common sites of herniation are the lumbosacral discs, specifically L4-5 and L5-S1. Discs herniation may also occur at C5-6 and C6-7.