This document discusses various bone disorders and their management. It covers classifications of bone disorders including hereditary, nutritional, hormonal and metabolic causes. Among metabolic bone disorders, it focuses on rickets, osteomalacia, osteoporosis and osteitis fibrosa cystica. For each condition, it describes etiology, clinical features, investigations and treatment approaches. Radiological findings and laboratory tests are emphasized for diagnosis. Management involves supplementation, medications, surgery and exercise depending on the specific bone disorder.

1. BONE
DISORDERS AND
MANAGEMENT
DR ARUNIMA P
2ND YR PG SCHOLAR
DEPARTMENT OF SHALYATANTRA
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2. INTRODUCTION
A condition or disease that affects the
flexibility, strength and normal growth of
bones are called as bone disorders.
In world 300 million people suffer from bone
related issues.
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3. CLASSIFICATION
Causes
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Hereditary
Nutritional
deficiency
Hormonal
Dystrophic
Inflammatory
Metabolic
Tumours and
neoplastic
Developmental
Idiopathic
Cystic

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5. Metabolic bone disorders
 200 million suffer from osteoporosis which comes under
metabolic bone disorders.
 Rickets
 Osteomalacia
 Osteoporosis
 Osteitis fibrosa cystica
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7. RICKETS
• Disease of growing skeleton
• Failure of normal mineralisation
• Seen prominently on growth plates
• Resulting in softening of bones and
development of deformities
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8. Types
Type 1
-Due to deficiency of vitamin D
-due to disturbance in vit D metabolism
Type 2
-Defective absorption of phosphates
through renal tubules
-diminished intake or absorption of
phosphates
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10. Commonest cause –poor socioeconomic
conditions
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12. • Delayed appearance of epiphysis
-widening of epiphyseal plates
-cupping of metaphysis
-fraying of metaphysis
-rarefaction
-bone deformities
RADIOLOGICAL FINDING
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13. LAB INVESTIGATIONS
Serum calcium usually low
serum phosphate low
serum alkaline phosphatase high
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14. Treatment
administration of vit D 6,00,000 units
CONSERVATIVE METHODS
Splints and shoes for deformities
Operative methods-corrective osteotomies
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15. Osteomalacia
Softening of bones,
It is adult counter part of rickets
Due to vit D deficiency
Aetiology
Lack of exposure to sunlight
Dietary deficiency of vitamin D
Malabsorption syndrome
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16. Clinical features
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17. INVESTIGATION
Radiological examination
Diffuse rarefraction of bones
Loosers zone (pseudo fractures)
Triradiate pelvis in females
Protrusio acetabuli
Bone biopsy confirms the diagnosis
Serum ca+ low,k+ low,ALP raised
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18. Treatment
Vit D supplementation therapy
In case of malabsorption higher dose or IM
Calcium supplementation given
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19. Osteitis fibrosa cystica
Occurs as part of hyperparathyroidism
Common in women
Features –
Bone pain
Pathological fracture
Browns tumour
Anorexia, nausea, vomiting,
Abdominal cramps
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20. Radiological investigations
Irregular, diffuse rare fraction of bones
Salt pepper appearance
Loss of lamina dura
Subperiosteal resorption
Browns tumour
Renal calculi
Other investigations-urinary excretion of calcium low, that of
phosphates high.
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21. Salt and pepper appearence
PATHOLOGICAL FRACTURE WITH BROWN TUMORS
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22. TREATMENT
Surgical excision of hormone secreting tissue
Deformities corrected surgically
Removal of calculi
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23. osteoporosis
Most commonest metabolic bone disease
More common in females
Characterised by diffuse reduction in the bone density due to decrease in the bone mass
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25. Clinical features
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26. Radiological features
COD FISH APPEARANCE
GROUND GLASS APPEARANCE OF THE BONES
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27. SINGHS INDEX
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28. INVESTIGATIONS:
Ca, K and ALP within normal limits
Total plasma proteins and plasma albumins may be
low
Bone biopsy
Neutron activation analysis
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29. TREATMENT
High protein diet
Calcium supplementation
Androgens
Oestrogen
Vitamin D
Calcitonin
Orthopaedic treatment
Exercises
Bracing to prevent Fractures
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