By Victor Parsons
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Additional info for A Colour Atlas of Bone Disease (Wolfe Medical Atlases)
Cartilage consists of a gell of water and acid mucopolysaccharides, such as chondroitin sulphate, combined with non-fibrous proteins and fibrous proteins including collagens and elastin. The cartilage model grows by appositional growth exteriorly and by interstitial growth down the length of the shaft. Ossification follows the differentiation of cells of the perichondrial membrane, a connective tissue sheath covering the bone, into osteoblasts. This occurs in mid-shaft and at both ends of the cartilage model.
I:\ \ j -7 .. ~ . 1. c . ,,~. ': ' ,,- . 152 Paget's ) ~ .. ,. . \ disease - mosaic cement . ~-~ . ,. ~- ,'" lines The skull when affected is grossly thickened and the sutures are obliterated (156). Occasionally at an early stage of the disease an area may be so rarefied as to suggest a bony defect (osteoporosis circumscripta 157). Thickening of the skull may 50 153 Paget's disease - osteoblastic activity -. ,"'~" ,;-. 154 I'aget's bone resorption has been followed by deposition of new bone.
I" . , ~ ~' ,. '::;"\:. ,~. , ;~~ ~.. >. <:. ' >~:. ~ , . ~. ' . \ I. J' 141 Steroid 144 Osteoporosis osteoporosis in thyrotoxicosis ~ , . ,,I , 'w'" , fractures (144) sometimes the causalion is multifaclorial: for example a post-menopausal female may be immobilised by rheumatoid arthritis and treated with corticosteroids . ', I'~ . ' .. :~, ,;. , to" ,1' 'r .. \J ~_. 47 145 Juvenile osh'Ooorosis 146 Osteoporosis cirrhosis in - transient osteoporosis (juvenile osteoporosis) in childhood affects a small group of apparently healthy children who become acutely osteoporotic.