By Victor Parsons
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Additional info for A Colour Atlas of Bone Disease (Wolfe Medical Atlases)
T( . For practical purposes osteoporosis IS classified according to its cause: - senile or post-menopausal: most osteoporotic patients are post-menopausal women. Compare the vertebrae from females aged 20 years and 80 years (139) disuse osteoporosis~may be localised or generalised. Immobilisation of a limb will lead to localised osteoporosis (140). Prolonged bed ~est, paralysis, physical inactivity and weight46 lessness of space flight can all lead to generalised osteoporosis Cushing's syndrome or prolonged corticosteroid therapy (141) both result in an increased urinary and faecal calcium excretion with a negative calcium balance resulting in osteoporosis.
On the surface of bone undergoing resorption they are seen in small pits (Howship's lacunae) which they have eroded (106 H&E x 250). Osteoblasts and osteoclasts are usually found in close prQximity (107 Goldner's stain x 200). The mechanism of resorption may be particularly evident appearing as 'snail tracks' on scanning electron microscopy (108). 106 Howship's lacunae -~. 107 Osteoblasts 38 and osteoclasts 3. Metabolic and endocrine bone disease Metabolic bone disease is largely a consequence of an upset in bone remodelling activity and/or mineralisation occurring at the periosteal, endosteal, haversian and trabecular surfaces.
Other causes include anticonvulsant drugs and excessive use of diphosphanates or aluminium hydroxide. pelvis deformity skin changes 39 c. Osteoporosis, clinical features shown in 110 d. Paget's disease of bone, clinical features shown in III e. With the introduction of haemodialysis in the 110 Osteoporosis - clinical treatment of chronic renal failure, renal osteodystrophy has become increasingly important. It has features of osteomalacia, hyperparathyroidism, osteoporosis and osteosclerosis III Paget's disease of bone features - clinical features rarely dementia osteoporosis circumscripta deafness and other cranial nerve disorders painful corrugated cervical cord lesions ervical spine compression horacic loss of vertebral height hypercementosis thyroid disorders spine compression ncreased vessel calcification ribs rubbing on iliac crest heart failure and block associated PXE cord compression coxa vara multiple collapse creases vascular calc,ification thin skin McConkey's sign degenerative disease skull platybasia and midbrain lesions femoral fractures and bleeding hip sarcoma fibular fractures metatarsal fractures PXE = pseudoxanthoma elasticum a.