#musculoskeletal

mynotes4usmle:

Paget Disease or Osteitis Deformans

Disorder in bone remodeling, 3 stages

1. Osteolytic (osteoclasts)
2. Mixed (osteclasts & osteoblasts)
3. Osteosclerotic (osteoblasts, “burn-out”)

Mosaic pattern on lamellar bone, big skull (no hat fits), foraminal narrowing (cranial nerve impingement), bone fractures, bone pain, warmth (increase vascularization).

Complications: AVshunt within bone marrow, can cause high output, cardiac failure, osteosarcoma

Possible underlying mechanism: Paramyxovirus infection of osteoclasts

Lab: Normal Calcium and Phosphate, INCREASED ALKALINE PHOSPHATASE

• MCC of an isolated, asymptomatic elevation of ALKALINE PHOSPHATASE in an elderly patient.
  
• Laboratory markers for bone turnover are elevated: PINP (procollagen type I N-propeptide or just remeber that song from 50cent “pimp”), urine hydroxyproline

• Imaging:XR (osteolytic or mixed lytic/sclerotic lesions), radionuclide bone scan (focal increase in uptake, also for staging)
• Tx:bibphosphonates

All you need to know about diagnosing compartment syndrome!!

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