logging in or signing up metabolic bone diseases naneria Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 7911 Category: Education License: All Rights Reserved Like it (9) Dislike it (0) Added: November 10, 2007 This Presentation is Public Favorites: 2 Presentation Description abnormalities of metabolism and harmonal immbalance causes many bone diseases like osteomalasia,osteoporosis, renal bone disease, flurosis, rickets, & space age disease. Comments Posting comment... By: tamam (33 month(s) ago) thanks alot it's great work Saving..... Post Reply Close Saving..... Edit Comment Close By: dr_nano (72 month(s) ago) it's good work and i hope to have more better Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Metabolic Bone Diseases: Metabolic Bone Diseases Vinod Naneria Consultant orthopaedic surgeon Choithram Hospital & Research Centre Indore , IndiaSkeleton: Skeleton 1 – 2 kg calcium, 1 kg phosphates Skeleton: SkeletonMetabolic bone disease: Metabolic bone diseaseImportance: Importance Past : Deficiency disease Present : Disabling disease Future : Space age diseaseKey-words: Key-wordsKey-players: Key-playersSlide8: Kidney G.I.Tract Bone Target Organs BMU‘S Bone Metabolic Unit: BMU‘S Bone Metabolic Unit Battle field BMU- steps: BMU- steps Activation: Osteoclasts Resorption: Bone matrix Reversal: pre-osteoblasts Formation: osteoid formation Mineralization: Quiescence Blue – the lining resting cell layer, Red – newly deposited osteoid, Green- mineralized bone, Dark green – old mature bone. Remodelling: RemodellingBMU: One BMU lasts about 11 seconds and represents about 6 months of real time. A micro-crack starts the process, the osteocytes sense damage and send signals into the marrow space. Preosteoclasts turn into multi-nucleated osteoclasts and start resorption, meanwhile preosteoblasts turn into osteoblasts and start forming osteoid (orange) which then mineralizes (green) BMUSlide13: The same thing is shown in the linear un animated slide.Calcium: CalciumCalcium metabolism: Calcium metabolismOsteomalacia: Osteomalacia Reduced mineralization of bone matrix due to calcium deficiency. Calcium deficiency Osteomalacia results when the osteoid does not have mineral.Menopausal Osteoporosis: Menopausal Osteoporosis Reduced bone mineral mass Normal mineral to matrix ratio. Estrogen deficiency The resorption cavities go a little deeper and resorption lasts a little longer, and the bone formation increases but doesn't quite match the higher resorption rate.Paget’s Disease: Paget’s Disease Increase rates of bone turn-over with development of disorganized woven bone.Slide21: Fast bone turn overTetracyline labeling: This animation shows a slice through a piece of bone about a millimeter long. It lasts 13 seconds and shows 30 months of real time. -10 BMU's in this view, each at a different stage. The bone formation rate in this movie is a bit above average, but within the normal range. -The shades of green represent the mineralization density: newly formed bone is not very dense (pale green) and older bone is denser (dark green). Tetracyline labelingSteroid induced bone disease: Steroid induced bone diseaseSlide24: Steroid Induced osteoporosis Corticosteroids increase the bone resorption rate and depth, similar to menopause. The steroids block action of osteoblasts, so the bone formation does not increase.Osteopetrosis: Osteopetrosis Failure of osteoclastic and chondroclastic resorption. Failure of remodelling Genetic disorderFluorosis: Fluorosis Abnormal matrix mineralization. Crystals of fluoroapatite replace calcium phosphate crystals of hydroxyapatite. Endemic in India Iatrogenic fluorosisPTH: PTH Change of shape of osteoblast secretion of neutral collagenase by osteoblast cells. Collagenase digests the protective layer of matrix exposing the bone surface for osteoclastic resorption. PTH receptors only on Osteoblasts PTH -> hypocalcemia: PTH -> hypocalcemia Calcium homeostasisSlide29: Hyper calcemia Hypo phoshphatemia Hyper calciuria High alk.phosphatase level PTH immune assay Ultrasosnography of neck. Disease of Stone & BoneVitamin D: Vitamin D The active hormone is 1,25(OH)2D3 responsible for the absorption of calcium from gut. Probably it acts indirectly by increasing serum calcium level thus reducing the effect of PTH on bone. Synthesized in SkinDeficiency of Vit. D: Deficiency of Vit. D Disease of Affluent classVitamin D Resistant Rickets: Vitamin D Resistant Rickets Defective final conversion of Vit. D in to active form.Slide33: Effect at growth end plateSlide34: Cupping of the epiphyses. Bones incapable of withstanding mechanical stresses and lead to bowing deformities. Eventual length of the long bones is diminished. ( short stature) Cont…..Slide35: Genu valgus Wrist cupping Tri radiate pelvis Looser’s zones Wrist widening Wide metaphysisRenal bone disease: Renal bone diseaseRenal Osteodystrophy: Renal OsteodystrophyCalcitonin: Calcitonin Anti - PTHCalcitonin: CalcitoninEstrogen: Estrogen Reloxiphen selectively on bone & not on breastEstrogen: Estrogen positive calcium balance. RELOXIPHEN: RELOXIPHEN This movie shows the effect of Raloxifene in women with osteoporosis. Bisphosphonates : Bisphosphonates Anti osteoclast Anti resorptiveSlide44: After the estrogen deficiency in the first 6 months show high turnover; then the little blue diamonds representing a bisphosphonate start to attach to the bone; resorption stops suddenly and formation stops after a few months. The bone continues to become more mineralized (darker), and only a few BMU's are still active. Bone Markers: Bone MarkersBone Markers: Bone MarkersSpace age bone disease: Space age bone diseaseSpace age bone disease: Space age bone disease Weightlessness in “Zero G”. Minimal mechanical stress on bone. numbers of osteoblasts. Osteoclast number – normal. NASA projects hPTH(1-31) as potent osteoblastic agent under extensive study. Effect of exercises in “Zero G”.Slide50: Bon VoyageSlide51: DISCLAIMER • Information contained and transmitted by this presentation is based on personal experience and collection of cases at Choithram Hospital & Research centre, Indore, India, during last 25 years. • It is intended for use only by the students of orthopaedic surgery. Many GIF files are taken from Internet. • Views and opinion expressed in this presentation are personal opinion. • Depending upon the x-rays and clinical presentations viewers can make their own opinion. • For any confusion please contact the sole author for clarification. Every body is allowed to copy or download and use the material best suited to him. I am not responsible for any controversies arise out of this presentation. • For any correction or suggestion please contact firstname.lastname@example.orgSlide52: THANK YOU You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.