Later irregular lytic destruction. TB and syphilis are rare causes of osteomyelitis. Metabolic Bone Disease A. Osteoporosis . May be localised e.g. following immobilisation post-fracture or adjacent to a rheumatoid joint. Defective bone mineralisation.
Sequelae are bone pain, fracture, proximal weakness and bone deformity.
Causes are inadequate diet, malabsorption, lack of exposure to sunlight, chronic liver disease, chronic renal disease, anticonvulsant therapy. Increased Ca and PO 4 excretion in urine. Skeletal changes of osteitis fibrosa cystica. D. Paget s Disease of bone - a disorder of bone turnover common in middle aged and elderly. Characterised by both lytic and sclerotic lesions.