Metabolic DIsorders Affecting Bone

Xray Of Bilateral Fracture Neck Of Femur With Deformed Pelvis In Osteomalacia

48 years, mother of five presented to out patient department with inability to walk and pains in all body for past five days. On further probing generalised body pains were present for about a Bilatreral hips were tender on examination.

Xray revealed fracture of neck of femur bilaterally and a deformed pelvis suggesting osteomalacia.

Fracture Neck femur in osteomalacia

Bilateral Fracture Neck femur in osteomalacia

Osteomalacia is a condition that occurs due to Vit D deficiency in adult [ In children the counterpart is rickets].

Osteomalcia leads to softening of bones and pseudofractures in regions like neck of femur, pubic rami etc which may on go to form complete fracture.

This patient was advised surgery [closed/open reduction+fixation] for both the neck of femur fracture but she refused any kind of surgical intervention.

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What Is Ochronosis?

The term Ochronosis was coined by Virchow who described yellow hue of cartilage [Ochre- yellow] under the microscope.

Ochronosis is the bluish black discoloration of certain tissues, such as the ear cartilage and the ocular tissue, seen primarily with alkaptonuria, a metabolic disorder.

Ochronosis can sometimes occur from exposure to substances like

  • Phenol
  • Trinitrophenol
  • Resorcinol
  • Mercury
  • Picric acid
  • Benzene
  • Hydroquinone
  • Antimalarials.

Alkaptonuria  causes accummulation and deposition of homogentisic acid  cartilage and resulting in causing the characteristic diffuse bluish black pigmentation. The accumulation of homogentisic acid inhibits collagen cross-linking by affecting a crucial enzyme in collagen synthesis, leading to a diminution of structural collagen integrity [Read more...]

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