Pathology Cheat Sheet
When Remodelling Runs Wild
Paget disease and rheumatoid arthritis for NEET-PG: mosaic bone, raised alkaline phosphatase, osteosarcoma risk, synovial pannus, RF, anti-CCP, and HLA-DR4.
MedNext Academy | 3 min read
When Remodelling Runs Wild
Paget disease and rheumatoid arthritis for NEET-PG: mosaic bone, raised alkaline phosphatase, osteosarcoma risk, synovial pannus, RF, anti-CCP, and HLA-DR4.
Paget disease of bone and rheumatoid arthritis, two disorders of disordered remodelling and chronic joint inflammation.
High-yield lines
- Paget disease of bone is disordered excessive bone remodelling of unknown cause with possible viral involvement.
- Paget disease passes through osteolytic, mixed, and osteosclerotic phases.
- Paget disease shows a mosaic pattern of lamellar bone with prominent cement lines.
- Paget disease raises serum alkaline phosphatase markedly with normal calcium and phosphate.
- Paget disease can cause bone pain, deformity, high-output cardiac failure, and osteosarcoma.
- Rheumatoid arthritis is a chronic systemic autoimmune disease affecting synovial joints symmetrically.
- Rheumatoid arthritis shows synovial pannus that erodes cartilage and bone.
- Rheumatoid factor is an autoantibody against the Fc portion of IgG.
- Anti-cyclic citrullinated peptide antibody is more specific for rheumatoid arthritis.
- Rheumatoid arthritis is associated with HLA-DR4.
- Rheumatoid nodules are areas of fibrinoid necrosis surrounded by palisading histiocytes.
- Rheumatoid arthritis causes symmetric small joint involvement with morning stiffness and ulnar deviation.
Mapped competency codes
- PA33.4
- PA33.5
Continue into the full chapter
This summary maps to PA33-bone-and-soft-tissue.
Frequently Asked Questions
What is the classic biochemical finding in Paget disease of bone?
A markedly raised serum alkaline phosphatase with normal serum calcium and phosphate, reflecting high bone turnover.
What is the histological hallmark of Paget disease?
A mosaic pattern of lamellar bone with irregular prominent cement lines from disordered remodelling.
Which antibody is most specific for rheumatoid arthritis?
Anti-cyclic citrullinated peptide (anti-CCP) antibody, which is more specific than rheumatoid factor for the disease.
What is a pannus in rheumatoid arthritis?
An inflamed proliferating synovial tissue that erodes and destroys the articular cartilage and subchondral bone of the joint.
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