骨关节疾病的学习资料.pptxVIP

骨关节疾病的学习资料第1页/共70页 Osteoporosis Osteoporosis is a disease characterized by increased porosity of the skeleton resulting from reduced bone mass. Generalized osteoporosis may be primary, or secondary to a large variety of conditions.第2页/共70页 The primary forms of osteoporosis are senile and postmenopausal osteoporosis; the former affects all aging individuals, while the latter affects only women after menopause.  The secondary osteoporosis is caused by endocrine disorders, gastrointestinal disorders, neoplasia, etc. and immobilization.第3页/共70页 第4页/共70页 Mechamism of osteoporosisMenopause AgingDecreased serum estrogen Decreased replicative activityIncreased IL-1, IL-6, of osteoprogenitor cells TNF levels Decreased synthetic activityIncreased expression of osteoblasts  of RANK, RANKL Decreased biological activity Increased osteoclast of matrix-bound growth factors activity Reduced physical activity第5页/共70页 第6页/共70页 Morphology The hallmark of osteoporosis is a loss of bone, which tends to be most conspicuous in parts of the skeleton containing abundant trabecular bone. In postmenopausal osteoporosis, the bone loss is often particularly severe in the vertebral bodies, which may fracture and collapse.第7页/共70页 第8页/共70页 The major microscopic changes are thinning of the trabeculae and widening of Haversian canals. Osteoclastic activity is present but is not dramatically increased. The mineral content of the remaining bone is normal, and thus there is no alteration in the ratio of minerals to protein matrix.第9页/共70页 第10页/共70页 第11页/共70页 Clinical Course  1. asymptomatic or pain until fracture 2. Thoracic and lumbar vertebral fractures 3. loss of height and various deformities, including kyphoscoliosis  The art for bone loss estimation involves specialized radiographic techniques to assess density, e.g., dual-energy absorptiometry and quantit