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BIO 2210

Skeletal Tissues and Bones


Chapter 6

Cells and Tissues

RECALL: The Four Primary Tissue Types that compose the body are:
-Epithelial Tissues: tissues that cover or line a structure, and that form Glands.

-Connective Tissues: tissues that provide a supporting function.


-Muscle Tissues: tissues that provide movement. -Nervous Tissues: tissues that serve a control role.
[Recall: Cartilage and Bone are Connective Tissues that are derived from the embryonic Mesoderm during Organogenesis.]

Cartilage: A Connective Tissue

There are three varieties of Cartilage:

1. Hyaline Cartilage 2. Elastic Cartilage


3. Fibrocartilage All three types of Cartilage are associated with the Human Skeleton.

Hyaline Cartilage

Elastic Cartilage

Fibrocartilage

Cartilages and the Human Skeleton

Hyaline Cartilages and the Skeleton

Skeletal Hyaline Cartilages include:


Articular* Cartilages, which cover the ends of most Bones at moveable Joints. Costal Cartilages, which connect the Ribs to the Sternum (breastbone).
*Articulation: a Joint between inflexible parts.

Hyaline Cartilages

Respiratory Cartilages, which form the skeleton of the Larynx and reinforce the Respiratory Passageways.

Nasal Cartilages, which support the External Nose.

Elastic Cartilages and the Skeleton

Elastic Cartilages occur in two locations: the External Ear. the Epiglottis, a laryngeal, flaplike structure that closes when we swallow so ingested substances do not enter the Larynx and airways.

Fibrocartilages and the Human Skeleton

Fibrocartilages occur at sites that are subjected to heavy pressure and stretch, such as the padlike cartilages (Menisci) of the Knee, the discs between the Vertebrae (Intervertebral Discs), and the Pubic Symphysis.

Cartilages

Cartilages are not innervated and generally contain no Blood Vessels.


Cartilages are often surrounded by a layer of Dense Irregular Connective Tissue called the Perichondrium, which contains Blood Vessels. The Perichondrium acts like a girdle by resisting outward expansion when Cartilage is compressed.

The structure labeled as P in the photomicrograph is the Perichondrium

Cartilages
Cartilages grow in two ways: 1. Appositional Growth (outward expansion due to the production of new Cartilage Matrix on the outer surface of a cartilagenous structure). Cartilage-forming cells (Chondroblasts) in the surrounding Perichondrium secrete new Matrix on the surface of existing cartilage tissue. 2. Interstitial Growth: Chondroblasts in Lacunae divide and secrete new Matrix, thereby expanding a cartilagenous structure from within. Cartilage growth ends when the Skeleton stops growing. During old age, Calcium Salts may be deposited in the Matrix of Cartilage (Calcification), which causes the Cartilage to harden and become more rigid and brittle.

Bone (Osseous) Tissue

Functions of Bones
Support: bones support the body and cradles the bodys soft organs. Protection: bones encase many body structures, e.g., the Skull protects the Brain, the Vertebrae surround the Spinal Cord, the Rib Cage protects organs in the Thoracic Cavity, and the Pelvic Girdle cradles organs in the Pelvic Cavity. Movement: Skeletal Muscles attach to Bones by Tendons and use Bones as Levers to provide Movement.

Functions of Bones

Mineral Storage: Bone serves as a reservoir for Minerals, especially Calcium and Phosphate.

Blood Cell Formation: Blood Cells are formed in Bone Marrow by a process called Hematopoiesis.

Potential Energy Source: Fat is stored in Bone Cavities.

Bones

Bones are Organs. [Recall: Organs are composed of different Tissues.] Bones contain Osseous Tissue (the most dominant tissue type), Nervous Tissue forms their Nerves, Cartilage is present in their Articular Cartilages, Fibrous Connective Tissue lines their surfaces and cavities, and Epithelial Cells and Smooth Muscle Cells are present in their Blood Vessels.

Bone (Osseous Tissue): Composition

Osseous Tissue consists of both Organic and Inorganic Substances.


Organic Components include Cells called Osteoblasts, Osteocytes, and Osteoclasts, and Osteoid, which is the organic part of the Bones Matrix. The Osteoid makes up ~1/3 of the Bones Matrix, and is composed of Ground Substance (Proteoglycans and Glycoproteins) and Collagen Fibers, which are produced by Osteoblasts. The remaining 65% of Bone consists of Inorganic Mineral Salts called Hydroxyapatites, which form tiny crystals that surround the Collagen Fibers. The crystals [Ca10(PO4)6(OH)2] give its hardness and strength.

The Bones: Learn them!!!


The Human Body contains 206 Bones, which are divided into two general groups: Axial Skeleton: bones that form the long axis of the body, including the Skull, Vertebral Column, and Rib Cage (Bony Thorax).

Appendicular Skeleton: bones of the upper and lower limbs, and the girdles (shoulder bones and hip bones) that attach the limbs to the Axial Skeleton.

Bone Markings; learn them!!!

Note: Bone Markings are anatomical landmarks that reveal sites of muscle attachments, points of articulation, and sites of blood vessels and nerve passageways.

Bone Markings: Learn them!!!

Classification of Bones
Bones are classified by their shapes:

Long Bones: considerably longer than they are wide, e.g., long limb bones, finger bones.
Short Bones: roughly cube shaped, e.g., bones of the wrist (Carpals) and ankle (Tarsals). [Note: Sesamoid Bones: short bones that form in a tendon, most notably the Patella (kneecap). Flat Bones: thin, flattened and usually somewhat curved bones, e.g., the Sternum (breastbone), the Ribs, the Scapulae (shoulder blades), and most Skull Bones.

Irregular Bones: bones with complicated shapes, including the Vertebrae and hip bones (Coxae).

Classification of Bones According to Their Shapes

General Bone Anatomy


Every Bone has an external dense layer composed of Compact Bone that appears smooth and solid. Internal to Compact Bone is Spongy Bone (Cancellous Bone), which has honeycomb-like spaces, or, in the case of Long Bones, a Medullary Cavity. The needle-like or flat bone pieces that form Spongy Bone are called Trabeculae.

Note: In Flat Bones, Spongy Bone is called Diploe.

Typical Long Bone Structure

Diaphysis: the tubular shaft that forms the bones long axis.
The Diaphysis is constructed of a relatively thick collar of Compact Bone that surrounds a Medullary Cavity or Marrow Cavity. In adults, the Medullary Cavity contains Fat (Yellow Marrow).

Long Bone Structure

Epiphyses (Epiphysis, singular): the more expanded bone ends. Compact Bone forms the exterior of the Epiphyses and the interiors of the Epiphyses contain Spongy Bone. The surfaces of Epiphyses at Joints are covered with a thin layer of Articular (Hyaline) Cartilage.

Long Bone Structure


An Epiphyseal Line is located between the Diaphysis and each Epiphysis. The Epiphyseal Line is a remnant of the Epiphyseal Plate, a disc of Hyaline Cartilage that grows during childhood to lengthen the Bone. The Epiphyseal Line or Epiphyseal Plate in childhood is sometimes called the Metaphysis.

Periosteum
With exception of Joint surfaces, Long Bones (and other Bones) are covered by a double -layered membrane called the Periosteum. The Outer Fibrous Layer consists of Dense Irregular Connective Tissue. The inner or Osteogenic Layer abutting the bone surface consists of bone-forming cells called Osteoblasts, bone-destroying cells called Osteoclasts, and Stem Cells called Osteogenic Cells that give rise to Osteoblasts.

Bone-Associated Cell Types

Periosteum
The Periosteum is attached to underlying bone by Perforating (Sharpeys) Fibers, which are Collagen Fibers that extend from the fibrous layer into the Bone Matrix. The Periosteum is supplied with Nerve Fibers and Blood and Lymphatic Vessels, which enter the Diaphysis via a Nutrient Foramen.

The Periosteum provides anchoring points for Tendons and Ligaments.

Long Bone Structure

Internal bone surfaces, including Spongy Bone Cavities, are covered by a delicate connective tissue membrane called the Endosteum. The Endosteum also lines canals that pass through Compact Bone. Like the Periosteum, the Endosteum contains Osteoblasts and Osteoclasts.

Microscopy of Osteocytes, Osteoblasts, and Osteoclasts

Osteocytes are encased in Lacunae of a bones Matrix.


Osteoblasts are found in rows on the internal and external surfaces of Bone. Osteoclasts are large, multinucleated cells found on the internal and external surfaces of Bone.

Structure of Short, Irregular, and Flat Bones


Short, Irregular, and Flat Bones all consist of relatively thin plates of Periosteum-covered Compact Bone on their surfaces and Endosteum-lined Spongy Bone on the inside.

Red Bone Marrow is present in the Spongy Bone. Short, Irregular, and Flat Bones have no Diaphysis or Epiphyses.

Hematopoietic (Blood Forming) Tissue in Bones

Hematopoietic Tissue called Red Bone Marrow, is found in the Trabecular Cavities of the Epiphyseal Spongy Bone of Long Bones. Hematopoietic Tissue is also located in the Spongy Bone of Short, Flat, and Irregular Bones (such as the Hip Bones). Yellow Marrow in Medullary Cavities can be replaced by Red Marrow in very Anemic individuals.

Micro-Anatomy of Compact Bone Though appearing dense and solid macroscopically, microscopy reveals that Compact Bone is riddled with passageways that contain Nerves, and Blood and Lymphatic Vessels.

Micro-Anatomy of Compact Bone The structural unit of Compact Bone is called the Osteon or the Haversian System.

An Osteon is a group of tubes of Bone Matrix, one placed outside the next like growth rings in a tree trunk. Each Osteon functions as a tiny weight bearing pillar.

Compact Bone and Osteons

Micro-Anatomy of Compact Bone

Each matrix tube is a Lamella (little plate). Collagen Fibers in a particular Lamella run in a single direction, while Collagen Fibers in adjacent Lamellae are arranged in opposite directions. The tiny crystals of Hydroxyapatite align with the Collagen Fibers so they alternate in direction in adjacent Lamellae. The Collagen Fibers give Bones their tensile strength (ability to resist stretching) and the Hydroxyapatites make Bones hard.

Micro-Anatomy of Compact Bone


A Central or Haversian Canal runs through the core of each Osteon. Haversian Canals contain small Blood Vessels and Nerves that serve the needs of the Osteons Cells. Other canals, called Perforating or Volkmanns Canals lie at right angles to the long axis of the bone and connect the blood and nerve supply of the Periosteum to those of the Haversian Canals and the Medullary Cavity.

Micro-Anatomy of Compact Bone Lacunae occur at the junctions of the Lamellae.


Small canals called Canaliculi connect the Lacunae to one another and to the Haversian Canal. During Bone Formation, Osteoblasts produce Bone Matrix and maintain contact with one another by tentacle-like projections that contain Gap Junctions. Spider-shaped Osteocytes (mature bone cells) occupy the Lacunae.

The Osteocytes in the Lacunae are structurally and functionally linked via their cytoplasmic extensions into the Canaliculi and by way of the Gap Junctions they form with one another.

Compact Bone
Not all Lamellae are part of Osteons.

Incomplete Lamellae called Interstitial Lamellae occur between Osteons. They are formed between Oseons or are remnants of former Osteons that remain after Bone Remodeling. Circumferential Lamellae are located beneath the Periosteum. They extend around the entire circumference of the Diaphysis and effectively resist twisting of a Long Bone.

Micro-Anatomy of Spongy Bone


Only a few cells thick, the Trabeculae of Spongy Bone contain irregularly arranged Lamellae and Osteocytes that are interconnected by Canaliculi. Unlike with Compact Bone, no Osteons per se are present in Spongy Bone. Nutrients reach the Osteocytes in Spongy Bone by diffusing through the Canaliculi from Capillaries in the Endosteum surrounding the Trabeculae. Spongy Bone contains Red Bone Marrow, which produces Bloods Red Blood Cells, White Blood Cells, and Platelets.

Spongy Bone

Red Bone Marrow

Ossification/Osteogenesis (Bone Formation)


Bones form from two general Processes:
1.

Intramembranous Ossification: formation of the Flat Bones (Cranial Bones) of the Skull (Frontal, Parietal, Occipital and Temporal Bones) and the formation of the Clavicles from Fibrous Connective Tissue.
Intramembranous Ossification begins at about Week 8 of Gestation. Bones formed by Intramembranous Ossification are called Membrane Bones.

2.

Endochondral Ossification: formation of all other Bones begins during the Second Month of Gestation and involves the replacement of Hyaline Cartilage structures with Bone Tissue.
Bones formed by Endochondral Ossification are called Endochondral Bones.
[Note: Before Week 8 of Gestation, the Skeleton of a Human Embryo is constructed entirely from Fibrous Membranes and Hyaline Cartilage.]

Steps Involved in Intramembrane Ossification

Steps Involved in Intramembrane Ossification

Steps Involved in Intramembrane Ossification

Steps Involved in Intramembrane Ossification

Summary of Intramembranous Ossification

Intramembranous Ossification

Initial Steps Involved in Endochondral Ossification


Endochondral Ossification uses Hyaline Cartilage bones as patterns for bone construction.

The process begins at the center of a Hyaline Cartilage Shaft as the Perichondrium (not shown in figure) becomes infiltrated with Blood Vessels.
The Perichondrium converts into a vascularized Periosteum (also not shown in figure). Osteoblasts of the newly formed Periosteum secrete Osteoid against the Hyaline Cartilage Diaphysis, encasing it in a Bone Collar.

[RECALL: Osteoid is the organic part of the Bone Matrix consisting of Ground Substance (Proteoglycans and Glycoproteins) and Collagen Fibers).]

Subsequent Steps Involved in Endochondral Ossification

Chondrocytes within the shaft undergo Hypertrophy (enlarge in size) and signal the surrounding Cartilage Matrix to Calcify.
The Diffusion of nutrients becomes limited by the formation of the Calcified Matrix, so the Chondrocytes die and the Cartilage Matrix deteriorates, causing the formation of cavities.

Steps Involved in Endochondral Ossification

During Month 3, the forming cavities are invaded by a collection of elements called the Periosteal Bud.
The Periosteal Bud contains a Nutrient Artery and Vein, Nerve Fibers, Red Marrow Components, Osteoblasts, and Osteoclasts.

Steps Involved in Endochondral Ossification


Entering Osteoclasts further erode the Calcified Cartilage Matrix. Osteoblasts secrete Osteoid around the remaining fragments of Hyaline Cartilage, forming bonecovered Cartilage Trabeculae. The Bone-Covered Cartilage Trabeculae are the earliest version of Spongy Bone in developing Long Bones.

Steps Involved in Endochondral Ossification


As the Primary Ossification Center enlarges, Osteoclasts break down the newly formed Spongy Bone and open a Medullary Cavity in the center of the Diaphysis. At Birth, most of our Long Bones have a Bony Diaphysis surrounding remnants of Spongy Bone, a widening Medullary Cavity, and two mainly Cartilagenous Epiphyses. Around the time of Birth, Secondary Ossification Centers develop in the Epiphyses, and the Epiphyses gain bony tissue after Birth.

Summary of Endochondral Ossification

Fetal Skeleton

By Birth, most Long Bones of the Skeleton are Ossified, except for their Epiphyses.

Steps Involved in Endochondral Ossification


When Secondary Ossification is complete, (i.e., the conversion of Hyaline Cartilage to Bone Tissue in the Epiphyses), Hyaline Cartilage remains in two places:
1) on the Epiphyseal Surfaces as Articular Cartilages, and 2) at the junctions of the Diaphysis and Epiphyses, where it forms Epiphyseal Plates.

Postnatal Bone Growth

During infancy and youth, Long Bones lengthen by Interstitial Growth of the Epiphyseal Plates and all Bones grow in thickness by Appositional Growth. Most Bones stop growing during Adolescence.

However, some Facial Bones, such as those of the Nose and the Mandible (lower jaw), continue to grow almost imperceptively throughout life.

Growth of Long Bone Length


Interstitial Growth: On the side of the Epiphyseal Plate facing an Epiphysis, Cartilage in a region called the Resting or Quiescent Zone is relatively inactive. The Epiphyseal Plate Cartilage facing the Diaphysis, on the other hand, organizes into a pattern that allows for fast growth. In this Growth Zone, the Cartilage Cells undergo Mitosis and form tall columns like coins in a stack. The rapidly dividing cells push the Epiphysis away from the Diaphysis, causing the Bone to lengthen.

Growth of Long Bone Length


Older Chondrocytes that are closer to the Diaphysis undergo Hypertrophy and their Lacunae erode and enlarge (the Hypertrophic Zone). Subsequently, the surrounding Cartilage Matrix calcifies, the Cartilage Cells die and deteriorate in a region called the Calcification Zone. Long calcified Cartilage Spicules remain at the Epiphysis-Diaphysis junction. In the Ossification Zone, the Cartilage Spicules are partly eroded by Osteoclasts and quickly covered with Bone Matrix produced by Osteoblasts, forming Spongy Bone.

Growth of Long Bone Length


During growth, the Epiphyseal Plate maintains a constant thickness because the rate of Cartilage Growth on its Epiphysisfacing side is balanced by the replacement with Bony Tissue on its Diaphysis-facing side.
As adolescence draws to an end, the Chondroblasts of the Epiphyseal Plate divide less often and the plates become thinner and thinner until they are entirely replaced by Bone Tissue. Longitudinal Bone Growth ceases when the Bony Tissues of the Epiphyses fuse with the Bone of the Diaphysis.

Long Bone Growth Longitudinal Bone Growth ceases when the Bone Tissue of the Epiphyses and Diaphysis fuses, called Epiphyseal Plate Closure, which usually occurs at ~18 and ~21 years of age in females and males, respectively.

Longitudinal Bone Growth is accompanied by almost continuous Remodeling of the Epiphyseal Ends to maintain the proper proportions between the Diaphysis and Epiphyses. [Note: Adult Bone can continue to increase in diameter or thickness by Appositional Growth if stressed by excessive muscle activity or body weight.]

Appositional Bone Growth

Ossification

Further Notes on Bone Growth:


In Short Bones, only Primary Ossification Centers form. In most Irregular Bones, bone formation occurs from several distinct Ossification Centers.

Growth of Long Bone Length

During Bone Growth, a bone undergoes Bone Remodeling to maintain its proper bone proportions.

Regulation of Bone Growth

During infancy and childhood, the most important stimulus of Epiphyseal Plate activity is Growth Hormone, which is secreted by the anterior lobe (Adenohypophysis) of the Pituitary Gland. Hypersecretion of Growth Hormone in children results in excessive height (Gigantism) Thyroid Hormones produced by the Thyroid Gland modulate the activity of Growth Hormone and helps ensure bones grow in proper proportions. Deficits in Growth Hormone and Thyroid Hormone produce characteristics of Dwarfism.

Regulation of Bone Growth by Sex Hormones

At Puberty, Sex Hormones (Testosterone in the male, Estrogen in the female) are produced in increasing amounts, initially producing the growth spurt typical of adolescence. Sex Hormones additionally cause the Masculinization of some bones in males and the Feminization of some bones in the female. Thereafter, the Sex Hormones induce Epiphyseal Closure, ending Longitudinal Bone Growth.

Bone Resorption/Remodeling
Small scale changes in bone architecture occurs continuously in our bodies as Bone is Resorbed and New Bone is formed. Every week, we recycle 5-7% of our Bone Mass and up to 0.5 g of Calcium may enter and/or leave the adult skeleton daily. Compact Bone is replaced ~every 10 years.
Spongy Bone is replaced ~every 3-4 years.
[Note: Bone Replacement is necessary because when bone remains in place for long periods, extensive Calcium Crystallizations over time make bone more brittle and subject to breakage.]

Osteoclasts and Bone Resorption/Remodeling


Osteoclasts are large, multinucleated cells that arise from the same Hematopoietic Stem Cells that produce Macrophages. Osteoclasts produce Lysosomal Enzymes that digest the organic Bone Matrix, and they additionally produce Hydrochloric Acid, which dissolves Calcium Salts.

As a result, pits called Howships Lacuna form where Bone is removed.

Remodeling and Interstitial Lamellae


Howships Lacuna formed by Osteoclasts enlarge to form Absorption Cavities, which become invaded by Blood Vessels, and Osteoblasts enter the cavities where they deposit new Concentric Lamellae around the blood vessels, thus forming new Haversian Systems. Interstitial Lamellae observed in Bone are usually remnants of remodeled Haversian Systems.

Bones and Mechanical Stress

Wolffs Law: a bone grows or remodels in response to the demands placed on it.
Long Bones are thickest midway along the Diaphysis where bending stresses are greatest. Curved Bones are thickest where they are most likely to buckle. The Trabeculae of Spongy Bone forms struts along lines of compression.

Large, Bony Projections occur where heavy, active muscles are attached.
[Note: Wolffs Law explains the featureless bones of the fetus and the Atrophied of bones of bedridden people.]

Bones and Mechanical Stress

Wolffs Law: a bone grows or remodels in response to the demands placed on it.

Regulation of Remodeling

Bone Remodeling is regulated by two control loops: Negative Feedback Hormonal ++ Mechanisms that maintain Ca levels in the Blood. Responses to Gravity and Mechanical Forces.

Bones and Mechanical Stress

Details about the mechanism(s) by which Bones respond to Mechanical Stress remain unclear, but
Bone Deformation produces an Electrical Current, as do some minerals when stressed (Piezo Electric Effect). Stretched and compressed bone regions are oppositely charged. Bone Tissue is deposited in negatively charged regions of stress, and bone is absorbed in unstressed areas of positive charge.

Hormonal Regulation of Blood Calcium


The body contains ~1,2001,400 g of Calcium (Ca++), with >99% as Bone Minerals. Most of the remainder is in Extracellular Fluids and in Cells. In addition to Bone Formation, Ca++ is necessary for: 1) Nerve Impulse Transmission, 2) Muscle Contraction, 3) Blood Coagulation, 4) Secretion by Glands, and 5) Cell Division.

Hormonal Regulation of Blood Calcium

Calcium Absorption from the Small Intestine is under the control of Vitamin D metabolites produced by the Skin.

Hormonal Regulation of Blood Calcium


Hypercalcemia (sustained high blood levels of Ca++) can result in the deposition of calcium salts in blood vessels, kidneys and other soft organs, which hampers their functions.

Note: the role of physiologic concentrations of Calcitonin in regulating the deposition of Calcium Salts is now being seriously questions.

Bone Fractures

Bone Fracture = Bone Break


Bone Fractures during youth usually occurs as a result of exceptional trauma, e.g., sports injuries, auto accidents, falls. Bone Fractures in old age frequently occur because bones have become thin and weakened.

Bone Fractures
Fracture Classifications Nondisplaced Fractures: bone ends retain their normal positions. Displaced Fractures: bone ends are out of normal alignment. Complete Fracture: bone is broken through. Incomplete Fracture: bone is not completely broken through. Linear Fracture: bone break parallels the bones long axis. Transverse Fracture: bone break is perpendicular to the bones long axis.

Open (Compound) Fracture: broken bone penetrates the skin.


Closed (Simple) Fracture: broken bone does not penetrate the skin.

Bone Fractures

Bone Fractures

Bone Fractures

Bone Repair

A Fracture is treated by Reduction, which is the realignment of the broken bones.

Closed Reduction: the bone ends are coaxed into place by the physician. Open Reduction: the bone ends are secured surgically with pins or wires or screws and plates. After a broken bone is Reduced, it is immobilized either by a cast or traction.

Stages of Bone Repair

1. When a bone breaks, Blood Vessels in the Bone and Periosteum are torn and Hemorrhage, causing a mass of clotted blood (Hematoma) to form at the fracture site.
Bone Cells derived of nutrition die, the tissue at the injured site becomes swollen, painful, and inflamed.

Stages of Bone Repair

2. Within a few days, Capillaries grow into the Hematoma, Phagocytic Cells endocytose debris, invading Fibroblasts produce Collagen Fibers that span the break, some Fibroblasts differentiate into Chondroblasts that secrete Collagen Matrix, and Osteoblasts begin forming Spongy Bone.

The entire mass of repair tissue, called the Fibrocartilaginous Callus, splints the broken Bone.

Stages of Bone Repair

3. Within a week, new Trabeculae appear and the Fibrocartilaginous Callus converts to a Bony (hard) Callus of Spongy Bone. Bony Callus formation continues until a firm union between the broken Bone parts is formed over a two month period.

Stages of Bone Repair

4. During Bony Callus formation and continuing for several months thereafter, the Bony Callus undergoes Remodeling. The Medullary Cavity is reformed and Compact Bone is laid down to reconstruct the walls of the Bone.

Osteoporosis

Osteomalacia: a condition in which bones are not adequately Mineralized. Osteoporosis: disease in which Bone Resorption outpaces Bone Deposition.
Bone Mass is reduced, causing bones to break easily.
Spongy Bone is most vulnerable, and Compression Fractures of the Vertebrae are common. The neck of the Femur is also very susceptible and prone to fracture (broken hip). [Note: Osteoporosis occurs most often in the aged, particularly in postmenopausal women.]

Osteoporosis

Osteoporosis is frequently treated with Calcium, Vitamin D supplements, weightbearing exercise, and Hormonal (Estrogen) Replacement Therapy (HRT).

Osteomalacia: Rickets

Rickets: analogous to Osteoporosis, but in children. Hallmarked by bowed legs and deformities of the pelvis, skull, and rib cage. Epiphyseal Plates cannot be calcified, so they continue to widen and the ends of long bones become visibly enlarged and abnormally long. Rickets is caused by insufficient Calcium in the diet or by Vitamin D deficiency. Treatment: Vitamin D-Fortified Milk and exposure to sunlight to stimulate Vitamin D production by the Skin.

Other Clinical Conditions and Terms

Achondroplasia: a congenital condition involving defective Cartilage and Endochondral Bone Growth so that limbs are too short; a type of Dwarfism. Ostealgia: pain in a Bone.

Osteitis: inflammation of Bony Tissue.


Osteomyelitis: inflammation of Bone and Bone Marrow caused by pus-forming bacteria that enter the body via a wound.

Other Clinical Conditions and Terms


Pagets Disease: characterized by excessive and haphazard Bone Deposition and Resorption at a usually localized site, with the Pagetic Bone having an abnormally high ratio of Spongy Bone to Compact Bone and reduced Mineralization. Pagets Disease occurs in ~3% of elder North American people, it generally affects the Spine, Pelvis, Femur and Skull, and its Etiology (cause) is unknown [Note: some evidence suggests it may be caused by a Virus].

Bony Spur: abnormal projection from a bone due to bony overgrowth; common in aging bones.
Osteosarcoma: a form of Bone Cancer typically arising in a Long Bone of a limb and most often in patients that are 10-25 years old. Osteosarcomas grow aggressively, they painfully erode bone, and they tend to Metastasize to the Lungs. Leukemias: a group of cancerous conditions involving the Bone Marrow and White Blood Cells. In all Leukemias, the Bone Marrow becomes almost totally occupied by Cancerous Leukocytes, and White Blood Cells flood the Bloodstream.