DISORDERS OF BONES

Overview
Bone spurs are bony projections that develop along bone edges. Bone spurs
(osteophytes) often form where bones meet each other — in your joints. They
can also form on the bones of your spine.
The main cause of bone spurs is the joint damage associated with osteoarthritis.
Most bone spurs cause no symptoms and can go undetected for years. They
might not require treatment. If treatment is needed, it depends on where spurs
are located and how they affect your health.
Symptoms
Most bone spurs cause no signs or symptoms. You might not realize you have
bone spurs until an X-ray for another condition reveals the growths. In some
cases, though, bone spurs can cause pain and loss of motion in your joints.
Specific symptoms depend on where the bone spurs are. Examples include:

 Knee. Bone spurs in your knee can make it painful to extend and bend
your leg.
 Spine. On your vertebrae, bone spurs can narrow the space that
contains your spinal cord. These bone spurs can pinch the spinal cord
or its nerve roots and can cause weakness or numbness in your arms or
legs.
 Hip. Bone spurs can make it painful to move your hip, although you
might feel the pain in your knee. Depending on their placement, bone
spurs can reduce the range of motion in your hip joint.
Causes
Joint damage from osteoarthritis is the most common cause of bone spurs. As
osteoarthritis breaks down the cartilage cushioning the ends of your bones, your
body attempts to repair the loss by creating bone spurs near the damaged area.
Bone Tumor
Bone tumors develop when cells within a bone divide uncontrollably, forming a
lump or mass of abnormal tissue.

Most bone tumors are benign (not cancerous). Benign tumors are usually not
life-threatening and, in most cases, will not spread to other parts of the body.
Depending upon the type of tumor, treatment options are wide-ranging—from
simple observation to surgery to remove the tumor.

Some bone tumors are malignant (cancerous). Malignant bone tumors

can metastasize—or cause cancer cells to spread throughout the body. In almost
all cases, treatment for malignant tumors involves a combination of
chemotherapy, radiation, and surgery.

Symptoms
Patients with a bone tumor will often experience pain in the area of the
tumor. This pain is generally described as dull and aching.  It may worsen at
night and increase with activity.

Other symptoms of a bone tumor can include fever and night sweats.

Many patients will not have any symptoms, but will note a painless mass
instead.

Although bone tumors are not caused by trauma, an injury can sometimes
cause a tumor to start hurting. Injury can also cause a bone that is weakened
by a tumor to fracture, or break. This may be severely painful.

Occasionally, benign tumors may be discovered incidentally when an x-ray

is taken for another reason, such as a sprained ankle or knee injury.

Osteoporosis Overview
Overview of Osteoporosis
Osteoporosis is a bone disease that develops when bone mineral density and
bone mass decreases, or when the quality or structure of bone changes. This can
lead to a decrease in bone strength that can increase the risk of fractures (broken
bones).

Osteoporosis is a “silent” disease because you typically do not have symptoms,

and you may not even know you have the disease until you break a bone.
Osteoporosis is the major cause of fractures in postmenopausal women and in
older men. Fractures can occur in any bone but happen most often in bones of
the hip, vertebrae in the spine, and wrist.

However, you can take steps to help prevent the disease and fractures by:

 Staying physically active by participating in weight-bearing exercises

such as walking.
 Drinking alcohol in moderation.

 Quitting smoking, or not starting if you don’t smoke.

 Taking your medications, if prescribed, which can help prevent fractures

in people who have osteoporosis.
 Eating a nutritious diet rich in calcium and vitamin D to help maintain
good bone health.
Causes of Osteoporosis

Osteoporosis occurs when too much bone mass is lost and changes occur in the
structure of bone tissue. Certain risk factors may lead to the development of
osteoporosis or can increase the likelihood that you will develop the disease.

Many people with osteoporosis have several risk factors, but others who
develop osteoporosis may not have any specific risk factors. There are some
risk factors that you cannot change, and others that you may be able to change.
However, by understanding these factors, you may be able to prevent the
disease and fractures.

Factors that may increase your risk for osteoporosis include:

 Sex. Your chances of developing osteoporosis are greater if you are a

woman. Women have lower peak bone mass and smaller bones than men.
However, men are still at risk, especially after the age of 70.
 Age. As you age, bone loss happens more quickly, and new bone growth
is slower. Over time, your bones can weaken and your risk for
osteoporosis increases.
 Body size. Slender, thin-boned women and men are at greater risk to
develop osteoporosis because they have less bone to lose compared to
larger boned women and men.
 Race. White and Asian women are at highest risk. African American and
Mexican American women have a lower risk. White men are at higher
risk than African American and Mexican American men.
 Family history. Researchers are finding that your risk for osteoporosis
and fractures may increase if one of your parents has a history of
osteoporosis or hip fracture.
 Changes to hormones. Low levels of certain hormones can increase your
chances of developing osteoporosis. For example:
 Low estrogen levels in women after menopause.

 Low levels of estrogen from the abnormal absence of menstrual

periods in premenopausal women due to hormone disorders or
extreme levels of physical activity.
 Low levels of testosterone in men. Men with conditions that cause
low testosterone are at risk for osteoporosis. However, the gradual
decrease of testosterone with aging is probably not a major reason
for loss of bone.
 Diet. Beginning in childhood and into old age, a diet low in calcium and
vitamin D can increase your risk for osteoporosis and fractures. Excessive
dieting or poor protein intake may increase your risk for bone loss and
osteoporosis.
 Other medical conditions. Some medical conditions that you may be
able to treat or manage can increase the risk of osteoporosis, such as other
endocrine and hormonal diseases, gastrointestinal diseases, rheumatoid
arthritis, certain types of cancer, HIV/AIDS, and anorexia nervosa.
 Lifestyle. A healthy lifestyle can be important for keeping bones strong.
Factors that contribute to bone loss include:
 Low levels of physical activity and prolonged periods of inactivity
can contribute to an increased rate of bone loss. They also leave
you in poor physical condition, which can increase your risk of
falling and breaking a bone.
 Chronic heavy drinking of alcohol  is a significant risk factor for
osteoporosis.
 Studies indicate that smoking is a risk factor for osteoporosis and
fracture. Researchers are still studying if the impact of smoking on
bone health is from tobacco use alone or if people who smoke have
more risk factors for osteoporosis.
Treatment of Osteoporosis

The goals for treating osteoporosis are to slow or stop bone loss and to prevent
fractures. Your health care provider may recommend:

 Proper nutrition.
 Lifestyle changes.
 Exercise.
 Fall prevention to help prevent fractures.
 Medications.

People who develop osteoporosis from another condition should work with their
health care provider to identify and treat the underlying cause. For example, if
you take a medication that causes bone loss, your doctor may lower the dose of
that medication or switch you to another medication. If you have a disease that
requires long-term glucocorticoid therapy, such as rheumatoid arthritis or
chronic lung disease, you can also take certain medications approved for the
prevention or treatment of osteoporosis associated with aging or menopause.

Nutrition

An important part of treating osteoporosis is eating a healthy, balanced diet,

which includes:

 Plenty of fruits and vegetables.

 An appropriate amount of calories for your age, height, and weight. Your
health care provider or doctor can help you determine the amount of
calories you need each day to maintain a healthy weight.
 Foods and liquids that include calcium, vitamin D, and protein. These
help minimize bone loss and maintain overall health. However, it’s
important to eat a diet rich in all nutrients to help protect and maintain
bone health.
Calcium and Vitamin D

Calcium and vitamin D are important nutrients for preventing osteoporosis and
helping bones reach peak bone mass. If you do not take in enough calcium, the
body takes it from the bones, which can lead to bone loss. This can make bones
weak and thin, leading to osteoporosis.

Good sources of calcium include:

 Low-fat dairy products.

  Dark green leafy vegetables, such as bok choy, collards, and turnip
greens.
 Broccoli.
 Sardines and salmon with bones.
 Calcium-fortified foods such as soymilk, tofu, orange juice, cereals, and
breads.

Vitamin D is necessary for the absorption of calcium from the intestine. It is

made in the skin after exposure to sunlight. Some foods naturally contain
enough vitamin D, including fatty fish, fish oils, egg yolks, and liver. Other
foods that are fortified with vitamin D are a major source of the mineral,
including milk and cereals.

What is arthritis?

Arthritis is a disease that affects your joints (areas where your bones meet and
move). Arthritis usually involves inflammation or degeneration (breakdown) of
your joints. These changes can cause pain when you use the joint.

Arthritis is most common in the following areas of the body:

 Feet.
 Hands.
 Hips.
 Knees.
 Lower back.

What are the parts of a joint?

Joints get cushioned and supported by soft tissues that prevent your bones from
rubbing against each other. A connective tissue called articular cartilage plays a
key role. It helps your joints move smoothly without friction or pain.

Some joints have a synovial membrane, a padded pocket of fluid that lubricates
the joints. Many joints, such as your knees, get supported by tendons and
ligaments. Tendons connect muscles to your bones, while ligaments connect
bones to other bones.

(Ligaments and tendons are both made of connective tissue and both can be torn
or overstretched, but they differ in function. Ligaments attach one bone to
another. Tendons attach a muscle to a bone. Both, however, are essential to
proper body mechanics. Muscles and nerve fibers allow a person to move their
body and enable the internal organs to function.
There are more than 600 muscles in the human body. A kind of elastic tissue
makes up each muscle, which consists of thousands, or tens of thousands, of
small muscle fibers. Each fiber comprises many tiny strands called fibrils.)

What are the different types of arthritis?

Arthritis is a broad term that describes more than 100 different joint conditions.
The most common types of arthritis include:

 Osteoarthritis, or “wear and tear” arthritis, which develops when joint

cartilage breaks down from repeated stress. It’s the most common form of
arthritis.
 Ankylosing spondylitis, or arthritis of the spine (usually your lower
back).
 Juvenile arthritis (JA), a disorder where the immune system attacks the
tissue around joints. JA typically affects children 16 or younger.
 Gout, a disease that causes hard crystals of uric acid to form in your
joints.
 Psoriatic arthritis, joint inflammation that develops in people
with psoriasis (autoimmune disorder that causes skin irritation).
 Rheumatoid arthritis, a disease that causes the immune system to attack
synovial membranes in your joints.

What causes arthritis?

Different types of arthritis have different causes. For instance, gout is the result
of too much uric acid in your body. But for other types of arthritis, the exact
cause is unknown. You may develop arthritis if you:

 Have a family history of arthritis.

 Have a job or play a sport that puts repeated stress on your joints.
 Have certain autoimmune diseases or viral infections.

What are the risk factors for arthritis?

Some factors make you more likely to develop arthritis, including:

 Age: The risk of arthritis increases as you get older.

 Lifestyle: Smoking or a lack of exercise can increase your risk of
arthritis.
  Sex: Most types of arthritis are more common in women.
 Weight: Obesity puts extra strain on your joints, which can lead to
arthritis.

What are the symptoms of arthritis?

Different types of arthritis have different symptoms. They can be mild in some
people and severe in others. Joint discomfort might come and go, or it could
stay constant. Common symptoms include:

 Pain.
 Redness.
 Stiffness.
 Swelling.
 Tenderness.
 Warmth.

How is arthritis treated?

There’s no cure for arthritis, but there are treatments that can help you manage
the condition. Your treatment plan will depend on the severity of the arthritis,
its symptoms and your overall health.

Conservative (nonsurgical) treatments include:

 Medication: Anti-inflammatory and pain medications may help relieve

your arthritis symptoms. Some medications, called biologics, target your
immune system’s inflammatory response. A healthcare provider may
recommend biologics for your rheumatoid or psoriatic arthritis.
 Physical therapy: Rehabilitation can help improve strength, range of
motion and overall mobility. Therapists can teach you how to adjust your
daily activities to lessen arthritic pain.
 Therapeutic injections: Cortisone shots may help temporarily relieve
pain and inflammation in your joints. Arthritis in certain joints, such as
your knee, may improve with a treatment called viscosupplementation. It
injects lubricant to help joints move smoothly.