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Haematological / Vascular Disorders of Bone (VASCULAR (Osteochondritis…

- - - - Erlenmeyer flask deformity Causes
        
        Lysosomal storage disease
        – Gaucher disease - osteopenia with Legg-Calvé-Perthes disease or Hass disease
        – Niemann-Pick disease
        Haemoglobinopathies
        – thalassaemia - coarsened trabeculation, cobweb appearance
        – sickle cell disease
        Bone dysplasias
        – fibrous dysplasia
        – osteopetrosis - diffuse sclerosis and sclerotic vertebral endplates (sandwich vertebrae)
        – craniometaphyseal dysplasia
        – metaphyseal dysplasia - Pyle disease
        – achondroplasia
        – Ollier disease
  - - - • Osteoporosis
        • lucent metaphyseal bands
        • Periostitis
        • lytic lesions
        • Splenomegaly
        • chloromas
        • myeloblasts
        • extramedullary manifestation
    - - periostitis
        
        lytic lesions
        
        granulocytic sarcoma
        
        osteoporosis
        
        lucent metaphyseal bands
        
        splenomegaly
- - - - Osteonecrosis Avascular, femoral / tibial condyles 60yo females
        
        complication of HIV, hip dislocation, femoral neck fractures
        
        heavy alcohol use, sickle cell disease, lupus, corticosteroid use.
        
        Legg-Calve-Perthes male 4-8yo flat & fragmented femoral head
        
        • capsular distention
        
        • joint space widening laterally, widened femoral neck
        • undergrowth of epiphysis
        
        • solid or patchy sclerosis
        
        • lucent crescent sign
        • gradual reconstitution of normal bone density and shape
        • coxa vara
        
        Freiberg's 2nd-5th metatarsals flat, irregular, sclerotic head 13-18yo females
        
        Kienbock's AVN Lunate
        
        excessive pressure on lunate
        
        collapse, fragmentation and sclerosis
        –ve ulnar variance (= unla falls shorter than radius line)
        
        Kohler's males 5-9yo
        
        flattened Talus / Navicular
        
        limping from pain and swelling in foot
        
        mimic normal growth variation before ossification
      - Trauma Non-avascular
        
        Osgood-Schlatter's tibial tuberosity fragmented
        
        • 11-15yo, Boys : girls = 3:1
        
        • bilateral
        
        • running, kicking and jumping
        
        • growth spurts
        
        Blount's
        
        Scheuermann's Dx 13-17yo
        
        irregular endplates T7-12
        
        thoracic kyphosis at least 3 spinal segments
        
        multiple schmorl’s nodes
        
        anterior wedging of VBs
        
        loss of disc heights
        
        thickened contracted ALL
        
        osteophyte formation
      - Growth Variants
        
        Sever's Disease calcaneal is sclerotic, fragmented