7.4.1 Common Disorders of Skeleton

Slipped Disc

• Each intervertebral disc is a cushion like pad which consists of nucleus pulposus and annulus fibrosis.
• Nucleus pulposus is an inner semifluid which acts as a rubber ball to give a disc its elasticity and compressibility.
• Annulus fibrosis is the strong outer ring of fibrocartilage, which holds together successive vertebrae.
• The discs act as shock absorber.
• Severe or sudden trauma to spines may result in herniation of one or more discs.
• The herniated disc or slipped disc usually involves rupture of annulus fibrosus followed by protrusion of the spongy nucleus pulposus.
• If protrusion presses on spinal cord or on spinal nerves, generate severe pain or even destruction of these nervous structures.
• 'Slipped disc' is misleading as it is not the whole disc that slides out of the position.

Spondylosis

• It is the immobility and fusion of vertebral joint.
• Cervical spondylosis results from chronic cervical degeneration, with herniation of disc and aging.

Sciatica

• Sciatica refers to pain, weakness, numbness, or tingling in the leg.
• It is caused by injury to or pressure on the sciatic nerve.
• Common causes of sciatica include:
• Slipped disk
• Pelvic injury or fracture
• Tumors

Arthritis

• It is the inflammation of joints.
• The typical symptoms of arthritis include:
• Pain after walking which may later occur even at rest
• Creaking sounds in joint
• Difficulty in getting up from a chair
• Pain on walking up and down stairs
• There are different types of arthritis:
• Osteoarthritis — a progressive disease in which the articular cartilages gradually soften and disintegrate; affects knee, hip and intervertebral joints.
• Rheumatoid arthritis — the result of an autoimmune disorder in which synovial membrane becomes inflamed due to faulty immune system.
• Gouty arthritis — results from a metabolic disorder in which an abnormal amount of uric acid is retained in the blood and sodium urate crystals are deposited in the joints; the most common joint affected is the joint of the big toe.

Osteoporosis

• Osteoporosis is a common disease characterised by reduced bone mass and an increased risk of fracture.
• In normal individuals, bone mass increases during skeletal growth to reach a peak between the ages of 20 and 25 but falls thereafter in both sexes.
• Osteoporosis occurs because in

Summary Table of Skeletal Disorders

Intermediate Level

Skeletal Disorders

Types of Arthritis

Osteoporosis

Formula / Mathematical Form

Not applicable to this topic.

Solved Example

Not applicable to this topic (descriptive topic).

Important Points

• 1. Skeletal deformation may be hereditary.
• 2. Skeletal deformation may be hormonal.
• 3. Skeletal deformation may be due to nutritional deficiency.
• 4. Slipped disc involves herniation of intervertebral disc.
• 5. Nucleus pulposus is the inner semifluid.
• 6. Annulus fibrosus is the outer ring of fibrocartilage.
• 7. Discs act as shock absorbers.
• 8. Slipped disc causes severe pain.
• 9. Spondylosis is immobility and fusion of vertebral joint.
• 10. Cervical spondylosis results from chronic degeneration.
• 11. Sciatica is pain, weakness, numbness, or tingling in the leg.
• 12. Sciatica is caused by pressure on the sciatic nerve.
• 13. Arthritis is inflammation of joints.
• 14. Symptoms of arthritis include pain and creaking sounds.
• 15. Osteoarthritis is a progressive disease.
• 16. Rheumatoid arthritis is an autoimmune disorder.
• 17. Gouty arthritis is a metabolic disorder.
• 18. Gouty arthritis affects the big toe.
• 19. Osteoporosis is reduced bone mass.
• 20. Osteoporosis increases the risk of fracture.

Remember

• - Slipped disc = herniation of intervertebral disc
• - Spondylosis = immobility and fusion of vertebral joint
• - Sciatica = pain, weakness, numbness, or tingling in the leg
• - Arthritis = inflammation of joints
• - Osteoarthritis = progressive disease; articular cartilages soften and disintegrate
• - Rheumatoid arthritis = autoimmune disorder
• - Gouty arthritis = metabolic disorder; uric acid crystals in joints
• - Osteoporosis = reduced bone mass; increased risk of fracture
• - Nucleus pulposus = inner semifluid
• - Annulus fibrosus = outer ring of fibrocartilage

Common Mistakes

• 1. Confusing slipped disc and spondylosis — Slipped disc = herniation; spondylosis = fusion.
• 2. Mixing up sciatica and arthritis — Sciatica = nerve pain; arthritis = joint inflammation.
• 3. Confusing the types of arthritis — Osteoarthritis, rheumatoid arthritis, gouty arthritis.
• 4. Forgetting the role of nucleus pulposus — Inner semifluid.
• 5. Mixing up annulus fibrosus and nucleus pulposus — Annulus = outer ring; nucleus = inner semifluid.
• 6. Believing slipped disc means the whole disc slides out — Only part of the disc protrudes.
• 7. Confusing osteoporosis and osteoarthritis — Osteoporosis = bone mass; osteoarthritis = joint cartilage.
• 8. Forgetting the affected joint in gouty arthritis — Big toe.
• 9. Mixing up the causes — Slipped disc: trauma; spondylosis: degeneration; sciatica: nerve pressure.
• 10. Thinking skeletal disorders cannot be managed — Many can be managed with treatment.

Quick Revision

Skeletal deformation may be hereditary e.g., arthritis may be hormonal e.g., osteoporosis or may be due to nutritional deficiency e.g., osteomalacia and rickets. Here we will describe slipped disc spondylosis, sciatica and arthritis. Each intervertebral disc is a cushion like pad which consists of nucleus pulposus and annulus fibrosis. Nucleus pulposus is an inner semifluid which acts as a rubber ball to give a disc its elasticity and compressibility. Annulus fibrosis is the strong outer ring of fibrocartilage, which holds together successive vertebrae. The discs act as shock absorber. Severe or sudden trauma to spines may result in herniation of one or more discs. The herniated disc or slipped disc usually involves rupture of annulus fibrosus followed by protrusion of the spongy nucleus pulposus. Spondylosis is the immobility and fusion of vertebral joint. Cervical spondylosis results from chronic cervical degeneration, with herniation of disc and aging. Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. Arthritis is the inflammation of joints. The typical symptoms of arthritis include pain after walking which may later occur even at rest, creaking sounds in joint, difficulty in getting up from a chair and pain on walking up and down stairs. Osteoarthritis is a progressive disease in which the articular cartilages gradually soften and disintegrate. Rheumatoid arthritis is the result of an autoimmune disorder in which synovial membrane becomes inflamed due to faulty immune system. Gouty arthritis results from a metabolic disorder in which an abnormal amount of uric acid is retained in the blood and sodium urate crystals are deposited in the joints. Osteoporosis is a common disease characterised by reduced bone mass and an increased risk of fracture.

60-Second Revision

• Slipped disc = herniation of intervertebral disc
• Spondylosis = immobility and fusion of vertebral joint
• Sciatica = pain, weakness, numbness, or tingling in the leg
• Arthritis = inflammation of joints
• Osteoarthritis = progressive disease; articular cartilages soften and disintegrate
• Rheumatoid arthritis = autoimmune disorder
• Gouty arthritis = metabolic disorder; uric acid crystals in joints
• Osteoporosis = reduced bone mass; increased risk of fracture
• Nucleus pulposus = inner semifluid
• Annulus fibrosus = outer ring of fibrocartilage
• Warning: Slipped disc is not the whole disc that slides out of position

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• 7. Support and Movement

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• 7.5 BONE FRACTURES

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