96. Ischemic and Infiltrative Disorders

  1. Clifford J. Rosen MD
  1. Richard W. Keen

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch96

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Keen, R. W. (2013) Ischemic and Infiltrative Disorders, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch96

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

SEARCH

Keywords:

  • histiocytosis-X;
  • ischemic bone disease;
  • systemic mastocytosis

Summary

Regional interruption of blood flow to the skeleton can cause ischemic (aseptic or avascular) necrosis. Ischemia, if sufficiently severe and prolonged, will kill osteoblasts and chondrocytes. Ischemic bone disease (Osteonecrosis) is often seen in association with a number of different conditions. Trauma with fracture of the femoral neck interrupts the major part of the blood supply to the head and may lead to osteonecrosis. Medical treatment includes non-weight-bearing for osteonecrosis affecting load-bearing bones. This may be for between 4 and 8 weeks. Vasoactive drugs such as prostacyclin may play a role in early stages of osteonecrosis. In systemic mastocytosis there is widespread infiltation of tissues with mast cells. These cells can be widely disributed in nearly every organ, and originate from bone marrow progenitor cells. Histiocytosis-X tends to be benign and self-limiting when there is no systemic involvement. Treatment for severe disease includes chemotherapy, radiation therapy, and immunotherapy.