"Achey" Bones?
Imbalances between bone deposit and bone resorption is what underlies nearly every disease that affects the human skeleton. Sufficient vitamin D, calcium, and weightbearing exercise all help to maintain healthy bone density.
4 Disorders in which the bones are inadequately mineralized; soft bones.
4 Disorders in which the bones are inadequately mineralized; soft bones.
Osteomalacia
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Rickets
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If a mother who breast-feeds her infant becomes vitamin D deficient because of lack of sun exposure or dreary winter weather, the infant too will be vitamin D deficient and will develop rickets.
What causes osteomalacia and rickets is insufficient calcium in the diet or by having a vitamin D deficiency.
Cures for osteomalacia and rickets can be achieved by increasing vitamin D intake and exposing the skin to sunlight (which spurs the body to form vitamin D).
What causes osteomalacia and rickets is insufficient calcium in the diet or by having a vitamin D deficiency.
Cures for osteomalacia and rickets can be achieved by increasing vitamin D intake and exposing the skin to sunlight (which spurs the body to form vitamin D).
Spondylosis |
Pelvic phleboliths |
Spondylosis is age-related change of the bones (vertebrae) and discs of the spine. These changes are often called degenerative disc disease and osteoarthritis. These changes don't always cause symptoms. But they are a common cause of spine problems that can range from mild to severe.(1)
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In most cases, pelvic phleboliths are benign. They don't require any further treatment or evaluation. They are recognized as a normal part of aging. In rare cases, the presence of phleboliths in the pelvis can alert your doctor to the possibility of more serious conditions, such as venous malformations.
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Osteoporosis |
Paget's disease
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Osteoporosis refer to a group of diseases in which bone resorption outpaces bone deposit.
Estrogen secretion decreases after menopause and this is strongly implicated in osteoporosis in older women. Insufficient bone stress. Low body weight or insufficient weight-bearing exercise hinders new bone deposit A diet poor in calcium, vitamin D, or protein. Smoking (which reduces estrogen levels and calcium absorption). Genetics. Osteoporosis runs in families. Hormone-related conditions such as diabetes mellitus and hyperthyroidism. Greater risk: consumption of alcohol or certain medications (such as steroids (after corticosteroid use), smoking, and certain cancer drugs). How can osteoporosis be prevented, or at least delayed?
-spinal flexion (can cause compression fractures) -mobilizations or traction -manipulations First Degree Osteoporosis cause occurs in elderly, post menopause Second Degree Osteoporosis cause: caused by hormone imbalance, intestinal malabsorption, prolonged periods of immobility after trauma or severe illness, tumors, or drug therapy Osteoporosis Signs and Symptoms -Low thoracic/lumbar pain, compression fractures, loss of height, increased thoracic kyphosis (Dowager's Hump) |
Paget's disease is characterized by excessive deposit of weak, poorly mineralized bone.
Disorder characterized by excessive bone breakdown and abnormal bone formation. It is often found in X rays which were taken for some other reason. It shows excessive and haphazard bone deposit and resorption. The newly formed bone, called pagetic bone is hastily made and has an abnormally high ratio of spongy bone to compact bone. The composition of a pagetic bone, its abnormally high ratio of spongy bone to compact bone and reduced mineralization. Late in Paget's disease: Osteoclast activity wanes, but osteoblasts continue to work, which results in often forming irregular bone thickenings or filling the marrow cavity with pagetic bone. It has a "moth-eaten" appearance of bone. Paget's disease may affect any part of the skeleton, but it is usually a localized condition. The spine, pelvis, femur, and skull are most often involved and become increasingly deformed and painful. Paget's disease rarely occurs before age 40, and it affects about 3% of North American elderly people. Paget's disease cause is unknown, but a virus may trigger the disease. Drug therapies used for Paget's disease that help prevent bone breakdown are bisphosphonates and calcitonin Notes: Padgett himself thought the 00:46 condition was due to inflammation of the 00:48 bone hence the term osteitis d Foreman's 00:52 D Foreman's referring to the deformity 00:54 that the disease produces |
Itai-itai (IID), Osteomalacia, Cadmium and Rheumatoid Disease
There was an endemic disease of unknown etiology in the Jinzu River basin of Toyama, Japan. It was a painful condition called 'itai-itai' (meaning 'ouch'). Patients complained of bone pain, especially in the pelvic girdle and legs while walking. It was in 1946, just after the Second World War, when itai-itai disease began to be medically evaluated. The local agricultural association requested Kanazawa University to conduct an investigation, Nagasawa et al., (1947) conducted this investigation and published their results the following year. In that paper, the authors referred to this endemic disorder as a rheumatoid disease.[1]
The 35-year history of 'itai-itai' has been divided into three periods: (1) 1955−1961, an early phase of epidemiology, symptom characterization and attempts at treatment; (2) a middle period during which diagnostic criteria were formalized and research focused on the influence of heavy metal contamination, particularly Cd; and (3) around 1970−1990, a third period in which the role of Cd accumulation in disease etiology was firmly established.[1]
Itai-itai disease (IID) is the most severe form of chronic cadmium (Cd) intoxication of human. The patients of IID suffer from renal anemia, tubular nephropathy and osteopenic osteomalacia, and 90% of the patients are post-menopausal women. Experiments [2] suggest concurrent administration of estradiol helps the vitamin D therapy for IID patients and the removal of Fe at the mineralization front of bone is important for the recovery to normal bone remodeling.
Source:
1. Keiko Aoshima, Itai-itai disease: Renal tubular osteomalacia induced by environmental exposure to cadmium—historical review and perspectives.
Soil Science and Plant Nutrition, 2016, Pages 319-326. https://www.tandfonline.com/doi/full/10.1080/00380768.2016.1159116
2. Takashi Umemura and Yumi Wako. Pathogenesis of osteomalacia in itai-itai disease. Journal of Toxicologic Pathology, 2006: 19: 69-74. https://www.jstage.jst.go.jp/article/tox/19/2/19_2_69/_pdf.
There was an endemic disease of unknown etiology in the Jinzu River basin of Toyama, Japan. It was a painful condition called 'itai-itai' (meaning 'ouch'). Patients complained of bone pain, especially in the pelvic girdle and legs while walking. It was in 1946, just after the Second World War, when itai-itai disease began to be medically evaluated. The local agricultural association requested Kanazawa University to conduct an investigation, Nagasawa et al., (1947) conducted this investigation and published their results the following year. In that paper, the authors referred to this endemic disorder as a rheumatoid disease.[1]
The 35-year history of 'itai-itai' has been divided into three periods: (1) 1955−1961, an early phase of epidemiology, symptom characterization and attempts at treatment; (2) a middle period during which diagnostic criteria were formalized and research focused on the influence of heavy metal contamination, particularly Cd; and (3) around 1970−1990, a third period in which the role of Cd accumulation in disease etiology was firmly established.[1]
Itai-itai disease (IID) is the most severe form of chronic cadmium (Cd) intoxication of human. The patients of IID suffer from renal anemia, tubular nephropathy and osteopenic osteomalacia, and 90% of the patients are post-menopausal women. Experiments [2] suggest concurrent administration of estradiol helps the vitamin D therapy for IID patients and the removal of Fe at the mineralization front of bone is important for the recovery to normal bone remodeling.
Source:
1. Keiko Aoshima, Itai-itai disease: Renal tubular osteomalacia induced by environmental exposure to cadmium—historical review and perspectives.
Soil Science and Plant Nutrition, 2016, Pages 319-326. https://www.tandfonline.com/doi/full/10.1080/00380768.2016.1159116
2. Takashi Umemura and Yumi Wako. Pathogenesis of osteomalacia in itai-itai disease. Journal of Toxicologic Pathology, 2006: 19: 69-74. https://www.jstage.jst.go.jp/article/tox/19/2/19_2_69/_pdf.
Genetic Bone Abnormality
Talipes Equinovarus
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Developmental Dysplasia of Hip (DDH)
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Torticollis
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Osteogenesis Imperfecta
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Marfan's Syndrome
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Osteopetrosis
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Muscular Dystrophy (MD)
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There is a genetic element to multiple sclerosis, as it is more common in family members of people with the disease. Some say MS is up to 80 times more common in first degree relatives like brothers, sisters or children of a person with MS.
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Other Bone Diseases
Spondylosis
-degenerative condition of discs at the facet joints
-Stress Fracture of Pars Interarticularis Radiculopathy -numbness and tingling feeling down nerves Spondylolisthesis -vertebrae slips forward and out of line Retrolisthesis -vertebra slips backwards out of line Osteoarthritis
Osteoarthritis Signs and Symptoms
Physical Therapy for Osteoarthritis
OA of the Hip
OA of the Knee
OA of the Hands
OA of the Feet
OA of the Vertebra Spondylosis, Radiculopathy, Spondylolysis, Spondylolisthesis, Retrolisthesis Osteoarthritis Process -damage to hyaline cartilage through splitting, causes it to absorb water -absorption of H20 causes cartilage to crack (fibrillation) -pieces of cracks flake off causing a locking of the joint (crepitus) -hyaline cartilage becomes thinner and wears away until none remains causing the bone beneath to be exposed -leads to bone on bone causing bone to become shiny and smooth (eburnation) -osteophytes (spurs) develop -synovial membrane becomes hypertrophied (produce less fluid) and ligaments degenerate |
Gout & Tophi
Gout
-Crystal-like arthritis, commonly found in big toe (MTP) -inability to metabolize uric acid -can also be found in the knee, ankle, elbow Tophi -uric acid in skin Hyperuricemia -increased uric acid in blood Tophi are chalky, gritty accumulations of uric acid crystals that build up in the soft tissue of a gouty joint, often occurring in the elbow or the joints of the fingers or toes. Tophi develop if gout is not treated for an extended period of time. Image below, Source: Dr Renu Madan Homoeopathic Centre https://renumadan.com/tophi/ Hemophilic Arthritis
-Type B Hemophilia (more severe)
-will be at risk for bleeding in body joints Hemoarthrosis -bleeding in joint causing articular cartilage to wear away Lyme Disease
Legg-Calve-Perthes Disease
Signs and Symptoms of Legg-Calve-Perthes
Osteomyelitis
Pott's Disease
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Bone Tumors
Osteosarcoma, Osteochondroma, Ewing's Sarcoma, Multiple Myeloma, Bone Metastases
Osteosarcoma
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Osteochondroma
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Ewing's Sarcoma
Chondroma
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Multiple Myeloma
Bone Metastases
Chondrosarcoma
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Myofascial Pain Syndrome: myofascial tissue is bound up causing pain
Fibromyalgia
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CRPS/RSD |
Fibromyalgia Etiology
Fibromyalgia S&S
Fibromyaligia Medicine/PT
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Complex Regional Pain Syndrome (CRPS)
Reflex Sympathetic Dystrophy (RSD)
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Synovial fluid
Every joint in our body has synovial fluid in it. This is the oil in our body that provides nutrition to the cartilage. Two things are required to produce that fluid: movement and compression. So if a joint doesn’t go through its full range—if the hips and knees never go past 90 degrees—the body says ‘I’m not being used’ and starts to degenerate and stops the production of synovial fluid.
A healthy musculoskeletal system has implications for our wider health. A 2014 study in the European Journal of Preventive Cardiology found that test subjects who showed difficulty getting up off the floor without support of hands, or an elbow, or leg (what’s called the “sitting-rising test”) resulted in a three-year-shorter life expectancy than subjects who got up with ease.
Ability to sit and rise from the floor as a predictor of all-cause mortality
Leonardo Barbosa Barreto de Brito, et al.
Eur J Prev Cardiol. 2014 Jul;21(7):892-8.
https://pubmed.ncbi.nlm.nih.gov/23242910/
A healthy musculoskeletal system has implications for our wider health. A 2014 study in the European Journal of Preventive Cardiology found that test subjects who showed difficulty getting up off the floor without support of hands, or an elbow, or leg (what’s called the “sitting-rising test”) resulted in a three-year-shorter life expectancy than subjects who got up with ease.
Ability to sit and rise from the floor as a predictor of all-cause mortality
Leonardo Barbosa Barreto de Brito, et al.
Eur J Prev Cardiol. 2014 Jul;21(7):892-8.
https://pubmed.ncbi.nlm.nih.gov/23242910/
Parts of a Synovial Joint
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How does a ligament effect a joint |
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Structures that increase stability of joint |
Collagen
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Periosteum
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Common causes of damage to nervous system:
diseases
infections lack of blood supply trauma/injury tumors neurotransmitter disorders genetic disorders structural change as in stenosis |
Major areas affected from nervous system damage:
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dermatomal - nerve root damage
non-dermatomal - along nerve pathway - local nerve compression hyporeflexia - absence of a reflex, a lower motor neuron problem biceps DTR nerve root - C5 brachioradialis DTR nerve root - C6 triceps DTR nerve root - C7 (kneecap) patellar DTR nerve root - L4 (2,3,4) achilles DTR nerve root (The ankle reflex )- S1 Purpose of Bone
Types of Bone Cells Osteoclasts - break down and reabsorb bone Osteoblasts - cells that produce new bone Osteocytes - -bone cells, found in lacunae of bone |
Juvenile RA
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Still's disease
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Bamboo Spine
Sacroiliitis
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Ankylosing Spondylitis
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Psoriatic Arthritis |
Pencil-in-Cup Deformity |
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Reactive Arthritis |
Scleroderma |
Systemic Lupus Erythematosus
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1. Calcinosis - deposition of calcium on skin 2. Raynaud's phenomenon - (above) 3. Esophageal hypomotility - slowed mechanism of swallowing 4. Sclerodactyly - thickening/tightness of skin of fingers and toes 5. Telangiectases - blood vessels dilated and visible on skin |
Rheumatoid Arthritis
-developing in synovial membrane from chronic inflammation -villi (fingerlike projections) form on this Joint appearance in RA
Muscle Atrophy in RA
Joint Deformities from RA -Trigger Finger -Boutonniere Deformity -Swan-neck Deformity -Ulnar Drift -changes at the Radioulnar joint -Carpal Tunnel Syndrome -Rheumatoid Foot -changes in Knee -changes to Cervical Spine Trigger Finger
Boutonniere Deformity
Swan-neck Deformity
Ulnar Drift (Z deformity)
Carpal Tunnel Syndrome Median nerve compressed from:
Rheumatoid Foot
RA joint deformity of the Knee
RA joint deformity of the cervical spine
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Symptoms of Rheumatoid Arthritis
Early staged RA affects these joints most
Later staged RA affects these joints most
-severe fatigue possibly related to anemia or anorexia, -Felty's syndrome -weight loss -skin nodules -scleritis -cataracts -Sjogren's syndrome -pleural effusion -interstitial lung disease -bronchiolitis -bronchiectasis -respiratory infection -osteoporosis -vasculitis -Raynaud's Phenomenon Felty's Syndrome
Must present with 4 of the following
-Radiological Testing -Laboratory Testing -Surgical Intervention -Pharmacology -Splinting Surgical Intervention of RA
Splinting to help RA
Physical Therapy interventions for RA -Hydrotherapy -Passive Stretching -Active Exercise -Electrical Modalities and Thermal Agents -Orthotics -Pain Reduction -Psychological Aspects -Nutrition Hydrotherapy for RA water temp kept between 90-100 degrees Gait Reeducation, stretch, and strengthening Passive Stretching for RA
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