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Skeletal disorders—general approach and clinical conditions 

Skeletal disorders—general approach and clinical conditions
Chapter:
Skeletal disorders—general approach and clinical conditions
Author(s):

B. Paul Wordsworth

, and M.K. Javaid

DOI:
10.1093/med/9780198746690.003.0466
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date: 27 February 2021

Bone is made up of (1) cells—osteoblasts, osteoclasts, and ostoecytes; and (2) extracellular mineralized matrix—roughly one-third organic (90% type 1 collagen) and two-thirds inorganic (mainly hydroxyapatite). Common presentations of bone disease include (1) deformity and short stature; (2) bone pain and fracture; (3) myopathy—in osteomalacia and rickets; (4) features of underlying disease (e.g. renal failure, myeloma). Many generalized disorders of the skeleton, such as osteoporosis, have entirely normal routine biochemical values. Radiographic imaging can be diagnostic in some cases, but MRI and CT are increasingly employed in addition to conventional (‘plain’) radiographs and bisphosphonate-labelled isotope scans. Bone biopsy is required for diagnosis in some circumstances. This chapter emphasizes those disorders in which impact on the skeleton is a substantial feature of the underlying condition.

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