Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Osteitis deformans ++ 731.0 Osteitis deformans without mention of bone tumor ++ M88.9 Osteitis deformans of unspecified bone ++ 4A: Primary Prevention/Risk Reduction for Skeletal Demineralization4B: Impaired Posture4C: Impaired Muscle Performance4F: Impaired Joint Mobility, Motor Function, Muscle Performance, ROM and Reflex Integrity Association With Spinal Disorders4G: Impaired Joint Mobility, Muscle Performance, and ROM Associated With Fracture +++ Description ++ Osteometabolic bone diseaseExcessive reabsorption of bone by osteoclasts, followed by vascular and fibrous tissue filling in the bone marrowWeakening of the bonesSlow progressive enlargement of the bonesAccelerated bone remodeling +++ Essentials of Diagnosis ++ Phase 1: Osteolytic phaseProminent bone reabsoprtionPhase 2: Sclerotic phaseDecreased cellular activityothPhase 3: Mixed phasedBoth active bone reabsorption and bone formation +++ General Considerations ++ Can be asymptomaticManaged with surgery or medicinePathologic fracturesCan cause paraplegia or stenosisPaget’s disease of the nippleChronic rash on the nipple +++ Demographics ++ More common with elderly, aging populationIndividuals with absorption issues in the intestinesMen > womenAnglo-Saxon descent +++ Signs and Symptoms ++ Bone growthBone painBone deformityEnlarged headHearing lossHeadachesJoint painTinglingMuscle weaknessNerve compressionJoint stiffnessGenu varusNeck painPathologic fracturesOsteoarthritisHeart failureBone cancer +++ Functional Implications ++ Delayed fracture unionHearing problemsGait dysfunction +++ Possible Contributing Causes ++ Age (>/= 50 years)Gender (female>male)No specific causeSeveral genes maybe relatedHereditaryInsufficient calcium and vitamin D +++ Differential Diagnoses ++ TraumaPathologic fracture from neoplasmOsteogenesis imperfectaInadequate mineralization of existing bone matrix (osteoid) or poor bone qualityOsteoporosisInfections, such as tuberculosisFibrous dysplasiaPeripheral neuropathyRepetitive stress fracturesMultiple myeloma, lymphoma, or metastatic cancerLeukemiaRenal osteodystrophyHormone deficiency (estrogen in women; androgen in men)Cushing’s syndrome or glucocorticoid administrationHyperthyroidismHyperparathyroidismHistory of drug abuse or misuse (alcohol, tobacco)Excessive vitamin D and AJuvenile osteoporosis occurs in children or young adults of both genders with normal gonadal function; onset typically occurs around age 8 to 14 years and hallmarks include rapid onset of bone pain and/or fracture secondary to traumaType I (Postmenopausal osteoporosis) typically occurs in women 50 to 65 years of age and is characterized by accelerated bone loss (trabecular bone)Type II (Age-associated or senile osteoporosis) presents in women and men older than 70 years of age as a result of bone loss associated with the aging process; fractures occur in both cortical and trabecular bone +++ Laboratory Tests ++ Serum calciumAlkaline phosphatase (ALP)Blood calcium levels24-hour urine calcium measurementThyroid function testParathyroid hormone levelsTestosterone level ... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free a profile for additional features.