Coloured X-ray of a sagittal section through a human skull.
“The skull has been sliced in half down the centre, revealing details of the internal structures. These include the delicate bones and spaces of the paranasal sinuses (around the nose and eyes, centre left). The fused bones of the cranium encase and protect the brain.
The nasal, cheek and upper jaw bones are fused to the cranium to form the facial skeleton (left). The lower jaw bone (mandible, lower left), is attached at flexible joints, allowing it to move. The upper and lower jaw bones contain 32 permanent teeth (lower left). The eye sockets (one at far left) house the eyes.”
•Osteoporosis is a disease characterized by the thinning of bones, with a consequent tendency to sustain fractures from minor stresses. Osteoporosis is the most common metabolic bone disease, and its name literally means “porous bone.” Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the loss of old bone. The disorder is most common in postmenopausal women over age 50.
•Osteomalacia is a condition in which the bones of an adult progressively soften because of inadequate mineralization of the bone. (In children the condition is called rickets.) Osteomalacia may occur after several pregnancies or in old age, resulting in increased susceptibility to fractures. Symptoms include bone pain, weakness, numbness of the extremities, and spasms of the hands or feet. Depletion of the bone minerals may be caused by lack of dietary vitamin D (or its precursor, ergosterol).
•Paget disease of bone, also called osteitis deformans, chronic disease of middle age, is characterized by excessive breakdown and formation of bone tissue. It is a localized disease that may be unifocal, affecting a single bone, or multifocal, affecting many bones or nearly the entire skeleton. For this reason, it is included among the metabolic bone diseases. Paget disease of bone is common among people of northern European descent, and it is almost nonexistent among people of Asian and African descent. The disease is characterized by excessive bone resorption, which is mediated by osteoclasts (cells that dissolve and absorb bone), and by excessive bone formation, which is mediated by osteoblasts (cells that synthesize bone).
•Marble bone disease also called osteopetrosis or Albers-Schönberg disease is a rare disorder in which the bones become extremely dense, hard, and brittle. Osteopetrosis is marked by increased bone density due to a defect in bone reabsorption by cells called osteoclasts. This leads to accumulation of bone with defective architecture, making them brittle and susceptible to fracture. In some cases, this is also accompanied by skeletal abnormalities. Although symptoms may not initially be apparent in people with mild forms of this disorder, trivial injuries may cause bone fractures due to bone fragility.
A 46-year-old man presented to the emergency department with worsening chronic left knee pain. Fourteen years before presentation, he had sustained a gunshot wound to the left knee. Radiographs obtained at the time of that injury showed a metallic bullet embedded in the posterior weight-bearing surface of the lateral femoral condyle and metallic debris within the joint (Panel A). No surgery was performed to remove the bullet at that time. At the current presentation, the physical examination was notable for a large effusion in the left knee. Repeat radiographs showed that, in addition to changes consistent with arthritis in the joint, the bullet had fragmented into metallic particles throughout the joint and synovium (Panel B). Laboratory studies revealed microcytic anemia, with a hemoglobin level of 9.1 g per deciliter (normal range, 12.9 to 16.8), and an elevated blood lead level (182 μg per deciliter [8.8 μmol per liter]). The Mini–Mental State Examination score was 24 (scores range from 0 to 30, with lower scores indicating poorer cognitive performance). The patient showed no other symptoms of chronic lead poisoning. Intraarticular bullets should be removed surgically at the time of the injury. In addition to causing joint damage, intraarticular bullets can fragment and dissolve in synovial fluid, leading to lead absorption and delayed symptomatic lead poisoning. The patient received chelation therapy. Surgical management with a left knee synovectomy was planned, but the patient left the hospital before surgery and was lost to follow-up.
3D CT reconstruction of a severe spinal fracture that occurred after the individual was involved in a high velocity collision and was ejected from their vehicle. Because of the level of this specific fracture there was minimal cord damage at the site, however this individual also suffered a fracture at the level of their cervical spine which resulted in paralysis.
Scoliosis is the abnormal curvature of the spine to the sides.
80% of cases are idiopathic, meaning that they have no known cause. The remainder are due to neuromuscular disorders, including Marfan’s syndrome (disorder of connective tissues), muscular dystrophy (a condition causing muscle weakness) and cerebral palsy (a neurological condition caused by brain damage).
Treatment includes back braces, pain management and in extreme cases, surgical correction.
That’s some insane misalignment! Most secondary schools nowadays screen for this, but not sure if that’s nationwide. Did your school include this in health checks/physicals?
