Bone diseases 2014

1. BONE DISEASES

2. BONE one of the hardest tissues of body Ch. Ch. By high elasticity B one is a calcified collagenous matrix with some cells entrapped in-between

3. TYPES OF BONE 3 types have been recognized 1- Lamellar bone = Mature bone 2- NON-Lamellar bone = Immature bone = WOVEN BONE 3- Bundle bone

4. Classification of bone diseases

5. HORMONAL BONE DISEASES

6. = Osteitis Fibrosa Cystica = Von Recklinghausen's disease of bone Hyperparathyrodism =  PTH ? In 2ry hyperparathyroidism, high levels of PTH do not cause hypocalcaemia 2 Types (1 ry , 2 ry hyperparathyroidism) are harmful to bone????!!!

7. Clinical features

8. Developmental BONE DISEASES

9. Fibrous Dysplasia of bone Bone is replaced by Fibrous C.T Fibrous Dysplasia of bone Fibrous Dysplasia of bone Fibrous Dysplasia of bone Bone is replaced by Fibrous C.T proliferating gritty Bone resorption Fibrous replacement Ossous metaplasia Woven Bone

10. Fibrous Dysplasia of bone Etiology ??!! 1. Non- Neoplastic growth 2. Abnormal reaction to traumatic episode. 3. Endocrinal disturbances. TYPES

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

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

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

14. Oral manifestation

15. Radiographic features 1. Mottled or Mixed 2. Radio-opaque. Lesions merge with normal bone at the margins (= ill defined) Lesion differ radiographoically according degree of osseous metaplasia

16. Histopathological features

17. Treatment Self limiting Cosmotic surgery may be needed

18. Dystrophic BONE DISEASES

19. Paget’s disease of bone Paget’s disease of bone 2 nd 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) Etiology ??!! Phases

20. Age uncommon before age 40 (=  40 years) Sex ♂> ♀ (2:1) Site vertebral column (1 st 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 S&S severe pain. Bones become larger….  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

21. Clinical features

22. Clinical features

23. Clinical features

24. Clinical features

25. Clinical features

26. Radiographical features

27. Histopathological features

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

29. Cherubism = familial fibrous dysplasia = familial multilocular cystic disease of jaws Age early childhood bn (2-4 years) Sex ♂ > ♀ Site Mand .> Max . S&S Bilateral ,Firm, painless swelling at angles of mand . Clinical features Pathogenesis