Septic arthritis is an infection of the joint space caused by bacteria, fungi, mycobacteria, and viruses. Septic arthritis typically involves large joints such as the knee, hip, and shoulder, though any joint can be affected. The knee is most commonly affected in adults, while the hip is most commonly affected in children. The bacteria responsible for septic arthritis vary by the age of the patient, though Staphylococcus aureus is a common pathogen across all age groups. Septic arthritis can lead to permanent joint damage unless treated expeditiously with joint irrigation and appropriate antibiotic treatment.Full Article - https://www.orthopaedia.com/septic-arthritis-2/
Osteomyelitis is an infection of the bone caused by bacteria, fungi, or mycobacteria. The infection can land in the bone via the bloodstream (hematogenous spread), contiguous spread from adjacent soft tissues, or direct inoculation during trauma, or surgery. The disease process is characterized by the progressive destruction of bone at the center of infection and new appositional bone growth around it. Osteomyelitis is found in both adults and children, though its presentation and prognosis are different in the two groups. Pediatric patients, whose bones have open growth plates, are accordingly more susceptible to infection, but this infection is likewise more...
Lyme disease results from infection of a tick-borne spirochete, Borrelia burgdorferi. It usually presents with a characteristic rash (“erythema migrans”) at the site of the tick bite. Often, symptoms are limited to headache, fever, muscle aches, and joint pain, though some patients may develop cranial nerve palsies, meningitis, or myocarditis/pericarditis. A late manifestation of Lyme disease is arthritis, typically affecting the knee. Lyme disease is named for the town in Connecticut where it was first diagnosed.Full Article - https://www.orthopaedia.com/lyme-disease/
The Female Athlete Triad was initially defined as the constellation of three interrelated clinical entities typically found in active young women: amenorrhea, osteoporosis, and disordered eating. The definition has now been broadened to recognize that each component of the triad exists on a spectrum. Thus, menstrual irregularities (without amenorrhea), low bone mineral density (without full-blown osteoporosis) and deficits of energy availability due to a deficient nutrition (without a formal diagnosis of an eating disorder) may be sufficient to prompt this diagnosis. Notably, the Triad can appear when there is not enough caloric intake to balance caloric expenditure, independent of whether...
Paget's disease of the bone is a condition of dysregulated bone remodeling, characterized by rapid osteoclastic bone resorption followed by increased osteoblastic bone formation. The resulting new bone is dense but structurally weak. The spine, skull, pelvis, femur, and tibia are the most common sites of disease. Bone overgrowth may cause pain, arthritis, and deformities (the latter giving rise to the condition’s historical name, osteitis deformans). The bone in Paget's disease is also susceptible to fracture. Although rare, a region of bone affected by Paget's disease can undergo malignant transformation into a sarcoma. Many cases of Paget’s disease are asymptomatic...
Osteoporosis (Greek for “porous bone”) is a disease of decreased bone density leading to a predisposition to fractures. Osteoporosis is extremely common, affecting more than 200 million people worldwide. Osteoporosis is defined by having a bone mineral density that is more than 2.5 standard deviations lower than the young adult mean. Osteoporosis most commonly affects the wrist, hips, and vertebrae. Osteoporosis is more common in women, who have an accelerated loss of bone density after menopause due to the decline in estrogen, in addition to normal age-related bone loss. A pre-osteoporosis state, osteopenia, is said to be present when bone...
Osteonecrosis is a disease process characterized by the ischemic death of subchondral bone, that is, bone under the cartilage near the joint surface, culminating in the possible collapse of the bone and damage to the joint. Osteonecrosis is distinguished from “bone infarction,” which is also characterized by ischemic death of bone – but in the diaphyseal shaft, and thus not associated with a risk of arthritis. Osteonecrosis is also known as “avascular necrosis” or “aseptic necrosis,” older terms that are no longer preferred. Osteonecrosis has many causes, including trauma, sickle cell disease, corticosteroid use, and excessive alcohol intake, though in...
Musculoskeletal tumors are a diverse group of neoplasms that arise from various tissues of the musculoskeletal system, including bone, cartilage, muscle, and connective tissue. These tumors can be benign or malignant and can present in any age group. The World Health Organization classifies musculoskeletal tumors (Table 1) as chondrogenic (cartilage forming), osteogenic (bone forming), fibrogenic, vascular, those derived from the notochord (an embryonic spinal structure), those with many osteoclastic cells, and hematopoietic neoplasms of bone. In addition, there is the large and important category of “other mesenchymal tumors of bone”, which includes more commonly seen conditions such as simple bone...
Metastasis is the process by which cancer spreads from its primary site of origin to other places in the body. Tumor cells escape from the primary tumor and travel in the blood stream or lymphatics to reach distal sites such as the skeleton. Skeletal metastases from carcinomas are the most common malignant tumors involving bone, far more common than primary bone tumors. Solid organ cancers most likely to spread to bone include cancers of the breast, lung, thyroid, kidney, and prostate. Blood cell cancers such as lymphoma and multiple myeloma are also commonly detected in the skeleton. Metastatic lesions are...
Frailty is a state of vulnerability associated with aging, physiological decline, and depleted reserves. Frail people have impaired homoeostasis. As such, a relatively minor stressor event (such as a fall from a standing height) brings with it a disproportionately high risk of adverse outcomes including disability, prolonged hospitalization, and mortality. In musculoskeletal medicine, the term “frailty” calls to mind osteoporosis and weakening of the bones, Additionally, there is loss of muscle mass (so-called sarcopenia), and with that, muscle weakness and impaired exercise tolerance. Nonetheless, even within musculoskeletal medicine, frailty is best understood as a whole-person concept, incorporating not only senescence...
