DISORDERS OF BONES AND JOINTS

Barbara J. Cohen,
Medical Terminology,
J.B. Lippincott Company, 1994, pp.445-450

Disorders of the skeleton often involve surrounding tissues-ligaments, tendons, and muscles,
and may be studied together as diseases of the musculoskeletal system. The medical specialty that
concentrates on diseases of the skeletal and muscular systems is orthopedics. Physical therapists
and occupational therapists must also understand these systems. Most abnormalities of the bones
and joints appear on simple x-rays. Radioactive bone scans, CT, and MRI scans are used as well.
Also indicative of disorders are changes in blood levels of calcium and alkaline phosphatase, an
enzyme needed for calcification of bone.
Infection
Osteomyelitis is an inflammation of bone (root oste/o) caused by pus-forming bacteria that
enter through a wound or are carried by the blood. Often the blood-rich ends of the long bones are
invaded, and the infection then spreads to other regions, such as the bone marrow and even the
joints. The use of antibiotics has greatly reduced the threat of osteomyelitis.
Tuberculosis may spread to bone, especially the long bones of the arms and legs and the
bones of the wrist and ankle. Tuberculosis of the spine is Potts disease. Infected vertebrae are
weakened and may collapse, causing pain, deformity, and pressure on the spinal cord. Antibiotics
can be used to control tuberculosis, as long as the strains are not resistant to these drugs and the host
is not weakened by other diseases.
Fractures
A fracture is a break in a bone. The effects of a fracture depend on the location and severity
of the break, the amount of associated injury, possible complications, such as infections, and
success of healing, which may take months. In a closed or simple fracture, the skin is not broken.
If the fracture is accompanied by a wound in the skin it is described as an open fracture. Reduction
of a fracture refers to realignment of the broken bone. If no surgery is required, the reduction is
described as closed; an open reduction is one that requires surgery to place the bone in proper
position.
Metabolic Bone Diseases
Osteoporosis is a loss of bone mass that results in weakening of the bones. A decline in
estrogen after menopause makes women over 50 most susceptible to this disorder. Efforts to
prevent osteoporosis include adequate intake of calcium, engaging in weight-bearing exercise, and
estrogen replacement therapy (ERT). Osteoporosis may also be caused by nutritional deficiencies,
disuse, as in paralysis or immobilization in a cast, and excess steroids from the adrenal cortex.
In osteomalacia there is a softening of bone tissue due to lack of formation of calcium salts.
Possible causes include deficiency of vitamin D, needed to absorb calcium and phosphorus from the
intestine, renal disorders, liver disease, and certain intestinal disorders. When osteomalacia occurs
in children, the disease is called rickets. It is usually due to deficiency of vitamin D.
Pagets disease (osteitis deformans) is a disorder of aging in which bones become larger but
weaker. It usually involves the bones of the axial skeleton, causing pain, fractures, and hearing loss.
With time there may be neurologic signs, heart failure, and predisposition to cancer of the bones.
Neoplasms
Osteogenic sarcoma (osteosarcoma) most commonly occurs in the growing region of a
bone, especially around the knee. This is a highly malignant tumor that often requires amputation. It
most commonly metastasizes to the lungs.
Chondrosarcoma usually appears in midlife. As the name implies, this tumor arises in
cartilage. It most frequently metastasizes to the lungs and may require amputation. In cases of
malignant bone tumors, early surgical removal is important to prevent metastasis. Signs of bone
tumors are pain, easy fracture, and increases in serum calcium and alkaline phosphatase. Aside from
primary tumors, neoplasms at other sites often metastasize to bone, most commonly to the spine.
Arthritis
In general, arthritis means inflammation of a joint. The most common form is
osteoarthritis or degenerative joint disease (DJD). This is a gradual degeneration of articular (joint)
cartilage due to wear-and-tear. It usually appears at midlife and beyond and involves the weight-
bearing joints and joints of the fingers. X-rays show a narrowing of the joint cavity and thickening
of the bone. The cartilage may crack and break loose, causing inflammation in the joint and
exposing the underlying bone. Osteoarthritis is treated with analgesics to relieve pain, anti-
inflammatory agents, such as corticosteroids, and nonsteroidal anti-inflammatory drugs (NSAIDs).
Rheumatoid arthritis is a systemic inflammatory disease of the joints that commonly
appears in young adult women. Its exact causes are unknown, but it may involve immunologic
reactions. A group of antibodies called rheumatoid factor often appears in the blood, but is not
always specific for rheumatoid arthritis, as it may occur in other systemic diseases as well. There is
an overgrowth of the synovial membrane that lines the joint cavity. As this covers and destroys the
joint cartilage, synovial fluid accumulates, causing swelling of the joint. There is degeneration of
the underlying bone, eventually causing fusion of the bones, or ankylosis. Treatment includes rest,
physical therapy, analgesics, and anti-inflammatory drugs.
Gout is caused by an increased level of uric acid in the blood, salts of which are deposited
in the joints. It mostly occurs in middle-aged men and almost always involves pain at the base of
the great toe. The cause may be a primary metabolic disturbance or a secondary effect of another
disease, as of the kidneys. Gout is treated with drugs to suppress formation of uric acid or to
increase elimination of uric acid (uricosuric agent).
Disorders of the Spine
Ankylosing spondylitis is a disease of the spine that appears mainly in males. Joint
cartilage is destroyed and eventually the disks between the vertebrae calcify and the bones fuse
(ankylosis). Changes begin low in the spine and progress upward, limiting mobility.
In cases of a herniated disk, the central mass (nucleus pulposus) of the disk between two
vertebrae ruptures into the spinal canal. This commonly occurs in the lumbosacral or cervical
regions of the spine as a result of injury or heavy lifting. The herniated or slipped disk puts
pressure on the spinal cord or spinal nerves, often causing pain along the sciatic nerve (sciatica).
There may be spasms of the back muscles leading to disability. Treatment is by bed rest and drugs
to reduce pain, muscle spasms, and inflammation, followed by an exercise program to strengthen
muscles. In severe cases, it may be necessary to perform a diskectomy (surgical removal of the
disk) and fuse the vertebrae.

Medical terminology
1. Match the following terms to their proper definitions: a) orthopedics, b) gout, c) Potts
disease, d) osteogenic sarcoma, e) fracture f) alkaline phosphatase, g) osteoarthritis, h)
osteoporosis, i) ankylosis, j) nucleus pulposus, k) osteomalacia, l) arthritis, m) ankylosing
spondylitis, n) herniated disk, o) Pagets disease, p) anti-inflammatory agent, q) osteomyelitis,
r) diskectomy, s) chondrosarcoma, t) nonsteroidal anti-inflammatory drug.

1. An enzyme needed in the formation of bone.
2. A chronic, progressive inflammatory disease involving the joints of the spine and
surrounding soft tissue. Most common in young males. Also called rheumatoid spondylitis.
3. Immobility and fixation of a joint.
4. Drug that reduces inflammation.
5. Inflammation of a joint.
6. A malignant tumor of cartilage.
7. Progressive deterioration of joint cartilage with growth of new bone and soft tissue in and
around the joint. The most common form of arthritis. Results from wear-and tear, injury, or
disease. Also called degenerative joint disease.
8. Surgical removal of a herniated intervertebral disk.
9. A break in a bone.
10. A form of acute arthritis, usually beginning in the knee or foot; caused by deposit of uric
acid salts in the joints.
11. Protrusion of the centre (nucleus pulposus) of an intervertebral disk into the spinal canal.
Pressure on nerve roots causes pain. Usually occurs in the cervical or lumbar region.
Ruptured or slipped disk.
12. Drug that reduces inflammation, but is not a steroid. Examples include aspirin and other
inhibitors of prostaglandins, which are naturally produced substances that promote
inflammation.
13. The central portion of an intervertebral disk
14. The study and treatment of disorders of the skeleton, muscles, and associated structures.
Literally straight (ortho) plus child (ped).
15. A malignant bone tumor; osteosarcoma.
16. A softening and weakening of the bones due to vitamin D deficiency or other disease
17. Inflammation of bone and bone marrow caused by infection, usually bacterial
18. A condition characterized by reduction in bone density. Most common in white women past
menopause. Causative factors include diet, activity, and estrogen levels.
19. Skeletal disease of the elderly, characterized by thickening and softening of bones and
bowing of long bones; osteitis deformans.
20. Inflammation of the vertebrae, usually caused by tuberculosis

2. Match the terms in each of theses sets with their definitions and write the
appropriate letter (a-e) to the left of each number.
__ 1. acetabulum a. bones of the ankle
__ 2. axis b. bones of the wrist
__ 3. phalanges c. socket for the head of the femur
__ 4. carpals d. second cervical vertebra
__ 5. tarsals e. bones of the fingers and toes

__ 6. metacarpals a. anterior bone of the pelvis
__ 7. patella b. facial bone
__ 8. pubis c. kneecap
__ 9. zygomatic d. bones of the hand
__ 10. occipital e. posterior skull bone

__ 11. osteoclast a. outgrowth of bone
__ 12. periosteum b. deficiency of bone tissue
__ 13. exostosis c. cell that destroys bone
__ 14. osteopenia d. bone projection at the elbow
__ 15. olecranon e. fibrous membrane around bone

__ 16. malleolus a. spinal tap
__ 17. myelopoiesis b. displacement of a vertebra
__ 18.spondylolisthesis c. bone projection at the ankle
__ 19. ankylosis d. immobility of a joint
__ 20. rachiocentesis e. formation of bone marrow

__ 21. meniscectomy a. removal of part of a vertebra
__ 22. lordosis b. removal of knee cartilage
__ 23. scoliosis c. partial dislocation
__ 24. laminectomy d. sideways curvature of the spine
__ 25. subluxation e. curvature of the lumbar spine