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1、Chapter17BoneandjointdiseasesDepartmentofPathologytheFirstAffiliatedHospital,SunYat-senUniversityWenJianmingNon-neoplasticdisordersOsteoporosisOsteoporosisisadiseasecharacterizedbyincreasedporosityoftheskeletonresultingfromreducedbonemass. Generalizedosteopor
2、osismaybeprimary,orsecondarytoalargevarietyofconditions.Theprimaryformsofosteoporosisaresenileandpostmenopausalosteoporosis;theformeraffectsallagingindividuals,whilethelatteraffectsonlywomenaftermenopause.Thesecondaryosteoporosisiscausedbyendocrinedisorders,g
3、astrointestinaldisorders,neoplasia,etc.andimmobilization.MechamismofosteoporosisMenopauseAgingDecreasedserumestrogenDecreasedreplicativeactivity IncreasedIL-1,IL-6,ofosteoprogenitorcells TNFlevelsDecreasedsyntheticactivity Increasedexpressionofosteoblasts ofR
4、ANK,RANKLDecreasedbiologicalactivity Increasedosteoclastofmatrix-boundgrowthfactors activityReducedphysicalactivityMorphologyThehallmarkofosteoporosisisalossofbone,whichtendstobemostconspicuousinpartsoftheskeletoncontainingabundanttrabecularbone.Inpostmenopau
5、salosteoporosis,thebonelossisoftenparticularlysevereinthevertebralbodies,whichmayfractureandcollapse.ThemajormicroscopicchangesarethinningofthetrabeculaeandwideningofHaversiancanals.Osteoclasticactivityispresentbutisnotdramaticallyincreased.Themineralcontento
6、ftheremainingboneisnormal,andthusthereisnoalterationintheratioofmineralstoproteinmatrix.ClinicalCourse1.asymptomaticorpainuntilfracture2.Thoracicandlumbarvertebralfractures3.lossofheightandvariousdeformities,includingkyphoscoliosisTheartforbonelossestimationi
7、nvolvesspecializedradiographictechniquestoassessdensity,e.g.,dual-energyabsorptiometryandquantitativeCT.OsteomyelitisOsteomyelitisarecausedbybacteria.Theoffendingorganismsreachthebonebyoneofthreeroutes:(1)hematogenousdissemination(mostcommon);(2)extensionfrom
8、aninfectioninadjacentjointorsofttissue;or(3)traumaticimplantationaftercompoundfracturesororthopedicprocedures.Overall,Staphylococcusaureusisthemostfrequentcausalorganism.MorphologyAcuteos
