Bone diseases usually occur due to an imbalance between bone synthesis and its destruction. Here we present the seven most common clinical pictures.
Unfortunately, due to the need for functional integration of each of its parts, the musculoskeletal system is sometimes prone to ailments. According to the World Health Organization (WHO), approximately more than 1.71 billion people suffer from at least one musculoskeletal disorder, making this group of pathologies the leading cause of disability in the world. Of all of them, low back pain stands out above the rest, being the leading cause of disability in 160 different countries.
In any case, beyond back pain, there are about 150 conditions that can impair the musculoskeletal system in the short or long term . This time we focus on the bone system, as we present the 7 most common bone diseases and their characteristics. Do not miss it.
- We recommend you read: “The 5 types of bones (according to their shape, structure or function)”
What are the most common bone diseases?
The WHO defines the disease as “the alteration or deviation of the physiological state in one or several parts of the body, for generally known causes, manifested by characteristic symptoms and signs, and whose evolution is more or less predictable”. On this occasion, the definition of irregularity applies to the bone system, which usually includes bones, cartilage and joint elements .
Most of these pathologies are characterized by low bone density that can lead to various fractures and clinical events, but not all bone diseases can be included in this etiological framework. Next, we show you the 7 bone diseases from a multifactorial point of view. Do not miss it.
1. Osteoporosis
Osteoporosis is the queen of bone diseases, as up to 80% of elderly women suffer from it . It is a loss of bone density. Although it may not seem like it, the bone system is very plastic and changes over time, as it contains mineral reserves that sometimes need to be used at a metabolic level by the body. 99% of the body’s calcium is stored in the bones, so it is usually necessary to absorb bone tissue at some point to release this secondary bioelement into the blood.
At 30 years of age peak bone mass is reached, that is, more bone has been produced than was reabsorbed. This balance is maintained for about 10 years, but then it begins to lose mass at a rate of 0.3-0.5% per year. In menopausal women this rate is drastically accelerated by hormonal imbalances, which is why osteoporosis is much more common in the female gender.
Ultimately, cortical bone thickness decreases and the internal porosity of the bones increases, predisposing them to fractures and injuries. Osteoporosis can lead to other bone clinical entities, such as fractures of the spine, fractures and sprains, among others .
2. Osteomyelitis
Osteomyelitis is a sudden or long-standing infection of the bone or bone marrow , usually caused by the pathogenic microorganism Streptococcus pyogenes or S. aureus. It commonly affects children and adolescents (with an epidemiological peak at 3 years of age). Its annual incidence rate is 1 patient per 5,000 healthy children.
These types of infections are usually secondary, that is, the pathogens come from another source and spread to the bone. The patient with osteomyelitis presents symptoms such as bone pain, fever, excessive sweating, swelling, malaise and many other signs. It is treated with specific antibiotics for long periods, since getting rid of the disease is usually quite complex due to the difficulty in accessing the bone at the pharmacological level.
3. Osteonecrosis
In osteonecrosis, a lack of blood flow causes bone tissue to deteriorate faster than it can be replenished , due to a lack of resources for the synthesis of hydroxyapatite crystals and other compounds. This clinical event can occur in one or several bones, although it is more common in the upper leg, arms, knees, shoulders and ankles.
The general incidence of this pathology is 4.7 cases per 10,000 people per year. Although its causes are not completely understood, long-term use of intravenous or oral steroids as drugs, alcohol use, HIV infection, and many other factors are suspected. The pathology can be prevented with analgesics and other approaches, but if the tissue damage is excessive, grafting and bone removal surgeries are used.
4. Malignant bone tumor
The most common malignant bone tumor is metastatic , considered a secondary tumor. This means that, in most cases, the cells of another tumor travel to the bones and establish themselves in them, causing the typical symptoms of a malignant neoplasm (uncontrolled cell mass growth).
On the other hand, the most common primary bone tumor is osteosarcoma. This variant represents 20% of bone cancers in use, but it occurs in less than one patient per 100,000 people. For this reason, almost always when we talk about bone cancer we associate it with metastasis from another tumor.
5. Osteoarthritis
As we have said, within the group of bone diseases tendons and joints are also taken into account. Osteoarthritis (OA) is the most common joint disorder, due to the aging, wear and tear of joint tissue . Almost 100% of the world population has symptoms of OA after 70 years of age, so it is considered an almost inevitable clinical entity after the passage of time.
This clinical picture causes pain, stiffness, tenderness, loss of flexibility, a creaking sensation and much more in the involved joints. It can be treated with over-the-counter pain medications (Paracetamol), physical therapy, occupational therapy, cortisone injections, and joint replacement in the most severe cases.
6. Scoliosis
Scoliosis is a lateral curvature of the spine that occurs during the development of the skeletal system, usually between childhood and puberty. It affects approximately 3% of adolescents in the world, and thanks to this figure it becomes one of the most common bone diseases in young people.
Although the causes of this condition are not known, its causality is attributed to neuromuscular conditions, birth defects that cause long-term problems, and spinal injuries or infections. This locomotor disease is treated with immobilization devices and/or surgery.
7. Paget’s disease
Paget’s disease (PD) is a chronic bone disorder in which bone is synthesized and destroyed faster than normal . Due to these drastic fluctuations, the bone system appears enlarged and fragile, which favors injuries and other events derived from the exogenous mechanical stress to which the organism is subjected.
This disease causes neurological, orthopedic and cardiovascular complications, so it is not limited only to the bones. The drugs used today in the treatment of PD are bisphosphonates, compounds that can reduce osteoclastic activity to normal. With proper treatment, the prognosis is positive.
Summary
We have presented you with a list of 7 more or less common bone diseases in general society, with multiple aetiologies and variable levels of involvement. Even so, without a doubt, the pathological conditions that stand out above the rest are osteoarthritis and osteoporosis. In some aging populations, both conditions can reach prevalences of up to 100%.
Many of these processes appear naturally with age, while others depend more on exogenous agents or bad luck (such as a tumor, osteonecrosis or osteomyelitis). Fortunately, there are effective treatments today to stop the progress of almost all of them .
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.
