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1、Chapter17BoneandjointdiseasesDepartmentofPathologytheFirstAffiliatedHospital,SunYat-senUniversityWenJianmingNon-neoplasticdisordersOsteoporosisOsteoporosisisadiseasecharacterizedbyincreasedporosityoftheskeletonresultingfromreducedbonemass. Generalizedosteoporosismaybeprimary,orseco
2、ndarytoalargevarietyofconditions.Theprimaryformsofosteoporosisaresenileandpostmenopausalosteoporosis;theformeraffectsallagingindividuals,whilethelatteraffectsonlywomenaftermenopause.Thesecondaryosteoporosisiscausedbyendocrinedisorders,gastrointestinaldisorders,neoplasia,etc.andimmo
3、bilization.MechamismofosteoporosisMenopauseAgingDecreasedserumestrogenDecreasedreplicativeactivity IncreasedIL-1,IL-6,ofosteoprogenitorcells TNFlevelsDecreasedsyntheticactivity Increasedexpressionofosteoblasts ofRANK,RANKLDecreasedbiologicalactivity Increasedosteoclastofmatrix-boun
4、dgrowthfactors activityReducedphysicalactivityMorphologyThehallmarkofosteoporosisisalossofbone,whichtendstobemostconspicuousinpartsoftheskeletoncontainingabundanttrabecularbone.Inpostmenopausalosteoporosis,thebonelossisoftenparticularlysevereinthevertebralbodies,whichmayfractureand
5、collapse.ThemajormicroscopicchangesarethinningofthetrabeculaeandwideningofHaversiancanals.Osteoclasticactivityispresentbutisnotdramaticallyincreased.Themineralcontentoftheremainingboneisnormal,andthusthereisnoalterationintheratioofmineralstoproteinmatrix.ClinicalCourse1.asymptomati
6、corpainuntilfracture2.Thoracicandlumbarvertebralfractures3.lossofheightandvariousdeformities,includingkyphoscoliosisTheartforbonelossestimationinvolvesspecializedradiographictechniquestoassessdensity,e.g.,dual-energyabsorptiometryandquantitativeCT.OsteomyelitisOsteomyelitisarecause
7、dbybacteria.Theoffendingorganismsreachthebonebyoneofthreeroutes:(1)hematogenousdissemination(mostcommon);(2)extensionfromaninfectioninadjacentjointorsofttissue;or(3)traumaticimplantationaftercompoundfracturesororthopedicprocedures.Overall,Staphylococcusaureusisthemostfrequentcausal
8、organism.MorphologyAcuteos
