METABOLIC BONE DISEASE

By Darti Wibisono
MS,SpPA

08/12/2018 created by Darti I Wibisono MS,SpPA

 AQUIRED PITUITARY GENETIC
D

EXOCRINE ENDOCRINE GLAND ORGAN

NORMAL BONES

METABOLIC BONE DISEASE

08/12/2018 created by Darti I Wibisono MS,SpPA

 MINERAL: HORMONAL ;
VITAMIN:
Calcium,phosphorus/phospha Parathroid
D
te,Magnesium Thyroid,ect

BONE

iosteoporosis, rickets, osteomalacia, osteogenesis imperfecta,

marble bone disease (osteopetrosis),Paget disease of bone,
fibrous dysplasia,ect

GSF BONE INJURY/ABNORMALITY

08/12/2018 created by Darti I Wibisono MS,SpPA

 • X-ray absorptiometry
• Bone densitometry

METABOLIC BONE BONE DENSITY

DISEASE (porotic)

BONE DEFORMITY
T –SCORE
(n=Z SCORE=0)

fibrous cystic
OSTEOPENIA = Tscore-1
FIBROUS DYSPLASIA OSTEOPORESIS= Tscore-2,5
Bone aneurysm
OSTEOGENESIS IMPERFECTA
FRACTURE

08/12/2018 created by Darti I Wibisono MS,SpPA

 ORGANIC/
CALCIUM NON ORGANIK
SUBTANCES ?
PHOSPHATE OSTEOID
(HYDROXYAPATITE)

NORMAL BONE

OSTEOCYTES OSTEOBLAST OSTEOCLAST

Giant multinucleated
cells

Digest and dissolve

Generate the
Nutritive cells the component of
protein matrix
bone

Metabolic
activity

08/12/2018 created by Darti I Wibisono MS,SpPA

 POROTIC
MBD

NORMAL BONE
CYSTIC

FIBROUS

08/12/2018 created by Darti I Wibisono MS,SpPA

 RICKETS
OSTEOMALACIA

Mineralization of osteoid is reduced

while bone mass remains normal.

PAGET DISEAS
(OSTEITIS DEFORMANS)

Excessive bone formation with

abnormal structure and impaired
stability.

08/12/2018 created by Darti I Wibisono MS,SpPA

 OSTEOPOROSIS

OSTEOPENIA = Tscore-1
OSTEOPORESIS= Tscore-2,5

FIBROUS DYSPLACIA

It may be associated with

endocrine abnormalities
with skin pigmentation

08/12/2018 created by Darti I Wibisono MS,SpPA

FIBROUS DYSPLASIA
 Ussually it caused by :
 Traumatic
 Degeneration of
underlying disease ( ANEURYSMAL BONE CYTS
Fibrous
dysplasia,osteoblast
oma,ect

08/12/2018 created by Darti I Wibisono MS,SpPA

 MBD

FRACTURE

HEALING PROCESS

REMODEL
RESOLUTION/
RECOVERY

NEOPLASIA

08/12/2018 created by Darti I Wibisono MS,SpPA

 GROWTH STIMULATING FACTORS

GROWTH OF VARIOUS CELL TYPES :

Platelet-derived
GROWTH OF growth
VARIOUS CELL TYPES :
• Platelet-derived
factor(PDGF) stimulates
growth
endothelialstimulates
factor(PDGF) cells,smooth muscle
endothelial
cells and muscle
cells,smooth fibroblast
cells and fibroblast
• Epidermal
Epidermal Growth
Growth Factor(EGF)
Factor(EGF)
Fibroblast ,epithelial,…………..
Fibroblast cells,ect
• Fibroblast
Fibroblast Growth
Growth FactorFactor
( FGF () FGF )
• Transforming
Transforming Growth
Growth FactorFactor
(TGF) (TGF)

08/12/2018 created by Darti I Wibisono MS,SpPA

 What is the difference between giant
cell ‘s from chronic osteomyelitis and
condroblastoma ?

08/12/2018 created by Darti I Wibisono MS,SpPA

 EWING’S SARCOMA

08/12/2018 created by Darti I Wibisono MS,SpPA

08/12/2018 created by Darti I Wibisono MS,SpPA