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    Sarah Joseph
    This chapter discusses metabolic bone diseases. It begins by providing background on bone biology, including the anatomy and cellular/molecular components of bone. It then discusses several specific bone diseases: osteoporosis, osteomalacia, chronic kidney disease-mineral and bone disorder, primary hyperparathyroidism, Paget's disease of bone, and genetic bone diseases like osteogenesis imperfecta. For each disease, it covers causes, clinical features, investigations/diagnosis, and treatment approaches. The chapter provides an overview of key bone diseases and how they impact bone structure and health.

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    First Page PDF

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    Sarah Joseph
    39 views1 page
    This chapter discusses metabolic bone diseases. It begins by providing background on bone biology, including the anatomy and cellular/molecular components of bone. It then discusses several specific bone diseases: osteoporosis, osteomalacia, chronic kidney disease-mineral and bone disorder, primary hyperparathyroidism, Paget's disease of bone, and genetic bone diseases like osteogenesis imperfecta. For each disease, it covers causes, clinical features, investigations/diagnosis, and treatment approaches. The chapter provides an overview of key bone diseases and how they impact bone structure and health.

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    Mineral disorder

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    This chapter discusses metabolic bone diseases. It begins by providing background on bone biology, including the anatomy and cellular/molecular components of bone. It then discusses several specific bone diseases: osteoporosis, osteomalacia, chronic kidney disease-mineral and bone disorder, primary hyperparathyroidism, Paget's disease of bone, and genetic bone diseases like osteogenesis imperfecta. For each disease, it covers causes, clinical features, investigations/diagnosis, and treatment approaches. The chapter provides an overview of key bone diseases and how they impact bone structure and health.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    39 views1 page

    First Page PDF

    Uploaded by

    Sarah Joseph
    This chapter discusses metabolic bone diseases. It begins by providing background on bone biology, including the anatomy and cellular/molecular components of bone. It then discusses several specific bone diseases: osteoporosis, osteomalacia, chronic kidney disease-mineral and bone disorder, primary hyperparathyroidism, Paget's disease of bone, and genetic bone diseases like osteogenesis imperfecta. For each disease, it covers causes, clinical features, investigations/diagnosis, and treatment approaches. The chapter provides an overview of key bone diseases and how they impact bone structure and health.

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    of 1

    CHAPTER 31

    Metabolic bone disease


    Timothy Cundy  •  Ian R. Reid  •  Andrew Grey

    CHAPTER OUTLINE

    BONE BIOLOGY  604 BONE DISEASE IN PRIMARY


    Anatomy of bone  604 HYPERPARATHYROIDISM  628
    Bone matrix proteins  605 Clinical, biochemical and histological
    Cellular elements of bone  607 features  628
    Biochemical markers of bone turnover  609 Treatment  629

    OSTEOPOROSIS  613 PAGET DISEASE OF BONE  629


    Causes of osteoporosis  614 Epidemiology  629
    Investigation and diagnosis  615 Aetiology  629
    Treatment  617 Natural history  629
    Pathology  630
    OSTEOMALACIA  620
    Clinical features  630
    Calciopenic osteomalacia  620
    Investigations  630
    Phosphopenic osteomalacia  622
    Responses to treatment  631
    Osteomalacia and acidosis  623
    Defective osteoblast function and BONE TURNOVER AND BONE DISEASE
    osteomalacia  623 IN CHILDREN  632
    CHRONIC KIDNEY DISEASE – MINERAL AND GENETIC BONE DISEASES  632
    BONE DISORDER  624 Osteogenesis imperfecta  632
    Aetiology  624 High bone mass  634
    Clinical features  625 Other disorders  634
    Investigations  625
    CONCLUSION  634
    Treatment  627
    Bone disease after renal transplantation  628 APPENDICES  635

    BONE BIOLOGY elements of bone can be packed together without inter-


    vening marrow spaces to form cortical or compact bone,
    The principal role of the skeleton is a structural one, or they can form an interlacing meshwork of trabeculae
    maintaining body shape, providing protection for inter- referred to as cancellous or trabecular bone. The diaph-
    nal organs and, together with the neuromuscular system, ysis of the long bone consists mainly of cortical bone,
    making locomotion possible. It also has an important whereas the metaphysis and epiphysis have a greater
    secondary role in mineral homoeostasis, functioning as quantity of trabecular bone, enclosed within a thin corti-
    a reservoir for calcium ions in particular. Metabolic bone cal envelope. Some 80% of the weight of an adult human
    diseases can affect both these functions. skeleton consists of cortical bone. However, the surface-
    to-volume ratio of trabecular bone is very much higher
    than that of cortical bone and it is metabolically much
    Anatomy of bone more active.
    Macroscopic
    Microscopic
    The anatomist classifies bones as being either flat (e.g.
    skull, scapula, mandible, ilium) or long (e.g. the limb At a microscopic level, bone consists of matrix (~35% by
    bones). Flat bones result from intramembranous ossifi- volume), mineral (~60%) and cells (<5%). The matrix is
    cation; long bones predominantly from endochondral predominantly type I collagen fibres, usually organized
    ossification. A long bone consists of a shaft (diaphysis) in layers within which the fibres are parallel to one an-
    broadening at either end into an epiphysis. The transi- other. In adult bone, the fibre orientation varies from
    tional zone between the diaphysis and the epiphysis is one layer to the next and this is referred to as lamellar
    termed the metaphysis. On sectioning a long bone, two bone. If deposited along a flat surface, the lamellae will
    patterns of organization of bone tissue are found. The be parallel to that surface, but in cortical bone they are

    604

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