able of Contents
SECTION 1—EMBRYOLOGY
DEVELOPMENT OF MUSCULOSKELETAL SYSTEM
1-1 Amphioxus and Human Embryo at 16
Days, 2
1-2 Differentiation of Somites into Myotomes,
Sclerotomes, and Dermatomes, 3
1-3 Progressive Stages in Formation of
Vertebral Column, Dermatomes, and
Myotomes; Mesenchymal Precartilage
Primordia of Axial and Appendicular
Skeletons at 5 Weeks, 4
1-4 Fate of Body, Costal Process, and Neural
Arch Components of Vertebral Column,
With Sites and Time of Appearance of
Ossification Centers, 5
1-5 First and Second Cervical Vertebrae at
Birth; Development of Sternum, 6
1-6 Early Development of Skull, 7
1-7 Skeleton of Full-Term Newborn, 8
1-8 Changes in Position of Limbs Before Birth;
Precartilage Mesenchymal Cell
Concentrations of Appendicular Skeleton
at 6 Weeks, 9
1-9 Changes in Ventral Dermatome Pattern
During Limb Development, 10
1-10 Initial Bone Formation in Mesenchyme;
Early Stages of Flat Bone Formation, 11
1-11 Secondary Osteon (Haversian
System), 12
1-12 Growth and Ossification of
Long Bones, 13
1-13 Growth in Width of a Bone and Osteon
Remodeling, 14
1-14 Remodeling: Maintenance of Basic
Form and Proportions of Bone During
Growth, 15
1-15 Development of Three Types of Synovial
Joints, 16
1-16 Segmental Distribution of Myotomes in
Fetus of 6 Weeks; Developing Skeletal
Muscles at 8 Weeks, 17
1-17 Development of Skeletal Muscle
Fibers, 18
1-18 Cross Sections of Body at 6 to
7 Weeks, 19
1-19 Prenatal Development of Perineal
Musculature, 20
1-20 Origins and Innervations of Pharyngeal
Arch and Somite Myotome Muscles, 21
1-21 Branchiomeric and Adjacent Myotomic
Muscles at Birth, 22
SECTION 2—PHYSIOLOGY
2-1 Microscopic Appearance of Skeletal
Muscle Fibers, 25
2-2 Organization of Skeletal Muscle, 26
2-3 Intrinsic Blood and Nerve Supply of
Skeletal Muscle, 27
2-4 Composition and Structure of
Myofilaments, 28
2-5 Muscle Contraction and Relaxation, 29
2-6 Biochemical Mechanics of Muscle
Contraction, 30
2-7 Sarcoplasmic Reticulum and Initiation of
Muscle Contraction, 31
2-8 Initiation of Muscle Contraction by Electric
Impulse and Calcium Movement, 32
2-9 Motor Unit, 33
2-10 Structure of Neuromuscular Junction, 34
2-11 Physiology of Neuromuscular
Junction, 35
2-12 Pharmacology of Neuromuscular
Transmission, 36
2-13 Physiology of Muscle Contraction, 37
2-14 Energy Metabolism of Muscle, 38
2-15 Muscle Fiber Types, 39
2-16 Structure, Physiology, and
Pathophysiology of Growth Plate, 40-41
2-17 Structure and Blood Supply of Growth
Plate, 42
2-18 Peripheral Fibrocartilaginous Element of
Growth Plate, 43
2-19 Composition and Structure of
Cartilage, 44
2-20 Bone Cells and Bone Deposition, 45
2-21 Composition of Bone, 46
2-22 Structure of Cortical (Compact) Bone, 47
2-23 Structure of Trabecular Bone, 48
2-24 Formation and Composition of
Collagen, 49
2-25 Formation and Composition of
Proteoglycan, 50
2-26 Structure and Function of Synovial
Membrane, 51
2-27 Histology of Connective Tissue, 52
2-28 Dynamics of Bone Homeostasis, 53
2-29 Regulation of Calcium and Phosphate
Metabolism, 54
2-30 Effects of Bone Formation and Bone
Resorption on Skeletal Mass, 55
2-31 Four Mechanisms of Bone Mass
Regulation, 56
2-32 Normal Calcium and Phosphate
Metabolism, 57
2-33 Nutritional Calcium Deficiency, 59
2-34 Effects of Disuse and Stress (Weight
Bearing) on Bone Mass, 60
2-35 Musculoskeletal Effects of Weightlessness
(Space Flight), 61
2-36 Bone Architecture and Remodeling in
Relation to Stress, 62
2-37 Stress-Generated Electric Potentials in
Bone, 63
2-38 Bioelectric Potentials in Bone, 64
2-39 Age-Related Changes in Bone
Geometry, 65
2-40 Age-Related Changes in Bone Geometry
(Continued), 66
SECTION 3—METABOLIC DISEASES
3-1 Parathyroid Hormone, 68
3-2 Pathophysiology of Primary
Hyperparathyroidism, 69
3-3 Clinical Manifestations of Primary
Hyperparathyroidism, 70
3-4 Differential Diagnosis of Hypercalcemic
States, 71
3-5 Pathologic Physiology of
Hypoparathyroidism, 72
3-6 Clinical Manifestations of Chronic
Hypoparathyroidism, 74
3-7 Clinical Manifestations of
Hypocalcemia, 75
3-8 Pseudohypoparathyroidism, 76
3-9 Mechanism of Parathyroid Hormone
Activity on End Organ, 77
3-10 Mechanism of Parathyroid Hormone
Activity on End Organ: Cyclic AMP
Response to PTH, 78
3-11 Clinical Guide to Parathyroid Hormone
Assay: Different Forms of PTH and Their
Detection by Whole (Bioactive) PTH and
I-PTH Immunometric Assays, 79
3-12 Clinical Guide to Parathyroid Hormone
Assay (Continued), 80
3-13 Childhood Rickets, 81
3-14 Adult Osteomalacia, 82
3-15 Nutritional Deficiency: Rickets and
Osteomalacia, 83
3-16 Vitamin D–Resistant Rickets and
Osteomalacia due to Proximal Renal
Tubular Defects (Hypophosphatemic
Rachitic Syndromes), 84
3-17 Vitamin D–Resistant Rickets and
Osteomalacia due to Proximal and Distal
Renal Tubular Defects, 85
3-18 Vitamin D–Dependent (Pseudodeficiency)
Rickets and Osteomalacia, 86
3-19 Vitamin D–Resistant Rickets and
Osteomalacia due to Renal Tubular
Acidosis, 87
3-20 Metabolic Aberrations of Renal
Osteodystrophy, 88
3-21 Rickets, Osteomalacia, and Renal
Osteodystrophy, 89
3-22 Bony Manifestations of Renal
Osteodystrophy, 90
3-23 Vascular and Soft Tissue Calcification in
Secondary Hyperparathyroidism of
Chronic Renal Disease, 91
3-24 Clinical Guide to Vitamin D
Measurement, 92
3-25 Hypophosphatasia, 93
3-26 Causes of Osteoporosis, 94
3-27 Involutional Osteoporosis, 95
3-28 Clinical Manifestations of
Osteoporosis, 96
3-29 Progressive Spinal Deformity in
Osteoporosis, 97
3-30 Radiology of Osteopenia, 98
3-31 Radiology of Osteopenia (Continued), 99
3-32 Radiology of Osteopenia (Continued), 100
3-33 Transiliac Bone Biopsy, 101
3-34 Treatment of Complications of Spinal
Osteoporosis, 102
3-35 Treatment of Osteoporosis, 103
3-36 Treatment of Osteoporosis
(Continued), 104
3-37 Osteogenesis Imperfecta Type I, 106
3-38 Osteogenesis Imperfecta Type III, 107
3-39 Marfan Syndrome, 108
3-40 Marfan Syndrome (Continued), 109
3-41 Ehlers-Danlos Syndromes, 110
3-42 Ehlers-Danlos Syndromes (Continued), 111
3-43 Osteopetrosis (Albers-Schönberg
Disease), 112
3-44 Paget Disease of Bone, 113
3-45 Paget Disease of Bone (Continued), 114
3-46 Pathophysiology and Treatment of Paget
Disease of Bone, 115
3-47 Fibrodysplasia Ossificans Progressiva, 116
SECTION 4—CONGENITAL AND
DEVELOPMENTAL DISORDERS
DWARFISM
4-1 Achondroplasia—Clinical
Manifestations, 118
4-2 Achondroplasia—Clinical Manifestations
(Continued), 119
4-3 Achondroplasia—Clinical Manifestations of
Spine, 120
4-4 Achondroplasia—Diagnostic Testing, 121
4-5 Hypochondroplasia, 122
4-6 Diastrophic Dwarfism, 123
4-7 Pseudoachondroplasia, 124
4-8 Metaphyseal Chondrodysplasia, McKusick
Type, 125
4-9 Metaphyseal Chondrodysplasia, Schmid
Type, 126
4-10 Chondrodysplasia Punctata, 127
4-11 Chondroectodermal Dysplasia (Ellis-van
Creveld Syndrome), Grebe
Chondrodysplasia, and Acromesomelic
Dysplasia, 128
4-12 Multiple Epiphyseal Dysplasia, Fairbank
Type, 129
4-13 Pycnodysostosis (Pyknodysostosis), 130
4-14 Camptomelic (Campomelic)
Dysplasia, 131
4-15 Spondyloepiphyseal Dysplasia Tarda
and Spondyloepiphyseal Dysplasia
Congenita, 132
4-16 Spondylocostal Dysostosis and Dyggve-
Melchior-Clausen Dysplasia, 133
4-17 Kniest Dysplasia, 134
4-18 Mucopolysaccharidoses, 135
4-19 Principles of Treatment of Skeletal
Dysplasias, 136
NEUROFIBROMATOSIS
4-20 Diagnostic Criteria and Cutaneous Lesions
in Neurofibromatosis, 137
4-21 Cutaneous Lesions in
Neurofibromatosis, 138
4-22 Spinal Deformities in
Neurofibromatosis, 139
4-23 Bone Overgrowth and Erosion in
Neurofibromatosis, 140
OTHER
4-24 Arthrogryposis Multiplex Congenita, 141
4-25 Fibrodysplasia Ossificans Progressiva and
Progressive Diaphyseal Dysplasia, 142
4-26 Osteopetrosis and Osteopoikilosis, 143
4-27 Melorheostosis, 144
4-28 Congenital Elevation of Scapula, Absence
of Clavicle, and Pseudarthrosis of
Clavicle, 145
4-29 Madelung Deformity, 146
4-30 Congenital Bowing of the Tibia, 147
4-31 Congenital Pseudoarthrosis of the Tibia
and Dislocation of the Knee, 148
LEG-LENGTH DISCREPANCY
4-32 Clinical Manifestations, 149
4-33 Evaluation of Leg-Length Discrepancy, 150
4-34 Charts for Timing Growth Arrest and
Determining Amount of Limb Lengthening
to Achieve Limb-Length Equality at
Maturity, 151
4-35 Growth Arrest, 152
4-36 Ilizarov and De Bastiani Techniques for
Limb Lengthening, 153
CONGENITAL LIMB MALFORMATION
4-37 Growth Factors, 154
4-38 Foot Prehensility in Amelia, 155
4-39 Failure of Formation of Parts: Transverse
Arrest, 156
4-40 Failure of Formation of Parts: Transverse
Arrest (Continued), 157
4-41 Failure of Formation of Parts: Transverse
Arrest (Continued), 158
4-42 Failure of Formation of Parts: Transverse
Arrest (Continued), 159
4-43 Failure of Formation of Parts: Transverse
Arrest (Continued), 160
4-44 Failure of Formation of Parts: Transverse
Arrest (Continued), 161
4-45 Failure of Formation of Parts: Transverse
Arrest (Continued), 162
4-46 Failure of Formation of Parts: Longitudinal
Arrest, 163
4-47 Failure of Formation of Parts: Longitudinal
Arrest (Continued), 164
4-48 Failure of Formation of Parts: Longitudinal
Arrest (Continued), 165
4-49 Failure of Formation of Parts: Longitudinal
Arrest (Continued), 166
4-50 Duplication of Parts, Overgrowth, and
Congenital Constriction Band
Syndrome, 167
SECTION 5—RHEUMATIC DISEASES
RHEUMATIC DISEASES
5-1 Joint Pathology in Rheumatoid
Arthritis, 170
5-2 Early and Moderate Hand Involvement in
Rheumatoid Arthritis, 171
5-3 Advanced Hand Involvement in
Rheumatoid Arthritis, 172
5-4 Foot Involvement in Rheumatoid
Arthritis, 173
5-5 Knee, Shoulder, and Hip Joint Involvement
in Rheumatoid Arthritis, 174
5-6 Extra-articular Manifestations in
Rheumatoid Arthritis, 175
5-7 Extra-articular Manifestations in
Rheumatoid Arthritis (Continued), 176
5-8 Immunologic Features in Rheumatoid
Arthritis, 177
5-9 Variable Clinical Course of Adult
Rheumatoid Arthritis, 178
TREATMENT OF RHEUMATOID ARTHRITIS
5-10 Exercises for Upper Extremities, 179
5-11 Exercises for Shoulders and Lower
Extremities, 180
5-12 Surgical Management in Rheumatoid
Arthritis, 181
SYNOVIAL FLUID EXAMINATION
5-13 Techniques for Aspiration of
Joint Fluid, 182
5-14 Synovial Fluid Examination, 183
5-15 Synovial Fluid Examination
(Continued), 184
JUVENILE ARTHRITIS
5-16 Systemic Juvenile Arthritis, 185
5-17 Systemic Juvenile Arthritis
(Continued), 186
5-18 Hand Involvement in Juvenile
Arthritis, 187
5-19 Lower Limb Involvement in Juvenile
Arthritis, 188
5-20 Ocular Manifestations in Juvenile
Arthritis, 189
5-21 Sequelae of Juvenile Arthritis, 190
OSTEOARTHRITIS
5-22 Distribution of Joint Involvement in
Osteoarthritis, 191
5-23 Clinical Findings in Osteoarthritis, 192
5-24 Clinical Findings in Osteoarthritis
(Continued), 193
5-25 Hand Involvement in Osteoarthritis, 194
5-26 Hip Joint Involvement in
Osteoarthritis, 195
5-27 Degenerative Changes, 196
5-28 Spine Involvement in Osteoarthritis, 197
OTHER
5-29 Ankylosing Spondylitis, 198
5-30 Ankylosing Spondylitis (Continued), 199
5-31 Ankylosing Spondylitis (Continued)
Degenerative Changes in the Cervical
Vertebrae, 200
5-32 Psoriatic Arthritis, 201
5-33 Reactive Arthritis (formerly Reiter
Syndrome), 202
5-34 Infectious Arthritis, 203
5-35 Tuberculous Arthritis, 204
5-36 Hemophilic Arthritis, 205
5-37 Neuropathic Joint Disease, 206
5-38 Gouty Arthritis, 207
5-39 Tophaceous Gout, 208
5-40 Articular Chondrocalcinosis
(Pseudogout), 209
5-41 Nonarticular Rheumatism, 210
5-42 Clinical Manifestations of Polymyalgia
Rheumatica and Giant Cell Arteritis, 211
5-43 Imaging of Polymyalgia Rheumatica and
Giant Cell Arteritis, 212
5-44 Fibromyalgia, 213
5-45 Pathophysiology of Autoinflammatory
Syndromes, 214
5-46 Cutaneous Findings in Autoinflammatory
Syndromes, 215
5-47 Joint and Central Nervous System Findings
in Autoinflammatory Syndromes, 216
5-48 Vasculitis: Vessel Distribution, 217
5-49 Vasculitis: Clinical and Histologic Features
of Granulomatosis with Polyangitis
(Wegener), 218
5-50 Key Features of Primary Vasculitic
Diseases, 219
5-51 Renal Lesions in Systemic Lupus
Erythematosus, 220
5-52 Cutaneous Lupus Band Test, 221
5-53 Lupus Erythematosus of the Heart, 222
5-54 Antiphospholipid Syndrome, 223
5-55 Scleroderma—Clinical Manifestations, 225
5-56 Scleroderma—Clinical Findings, 226
5-57 Scleroderma—Radiographic Findings of
Acro-osteolysis and Calcinosis Cutis, 227
5-58 Polymyositis and Dermatomyositis, 228
5-59 Polymyositis and Dermatomyositis
(Continued), 229
5-60 Primary Angiitis of the Central Nervous
System, 230
5-61 Behçet Syndrome, 232
5-62 Behçet Syndrome (Continued), 233
SECTION 6—TUMORS OF
MUSCULOSKELETAL SYSTEM
6-1 Initial Evaluation and Staging of
Musculoskeletal Tumors, 236
6-2 Osteoid Osteoma, 238
6-3 Osteoblastoma, 239
6-4 Enchondroma, 240
6-5 Periosteal Chondroma, 241
6-6 Osteocartilaginous Exostosis
(Osteochondroma), 242
6-7 Chondroblastoma and Chondromyxoid
Fibroma, 243
6-8 Fibrous Dysplasia, 244
6-9 Nonossifying Fibroma and Desmoplastic
Fibroma, 245
6-10 Eosinophilic Granuloma, 246
6-11 Aneurysmal Bone Cyst, 247
6-12 Simple Bone Cyst, 248
6-13 Giant Cell Tumor of Bone, 249
6-14 Osteosarcoma, 250
6-15 Osteosarcoma (Continued), 251
6-16 Osteosarcoma (Continued), 252
6-17 Chondrosarcoma, 253
6-18 Fibrous Histiocytoma and Fibrosarcoma of
Bone, 254
6-19 Reticuloendothelial Tumors—Ewing
Sarcoma, 255
6-20 Reticuloendothelial Tumors—
Myeloma, 256
6-21 Adamantinoma, 257
6-22 Tumors Metastatic to Bone, 258
6-23 Desmoid, Fibromatosis, and
Hemangioma, 259
6-24 Lipoma, Neurofibroma, and Myositis
Ossificans, 260
6-25 Sarcomas of Soft Tissue, 261
6-26 Sarcomas of Soft Tissue (Continued), 262
6-27 Sarcomas of Soft Tissue (Continued), 263
6-28 Tumor Biopsy, 264
6-29 Surgical Margins, 265
6-30 Reconstruction after Partial Excision
or Curettage of Bone (Fracture
Prophylaxis), 266
6-31 Limb-Salvage Procedures for
Reconstruction, 267
6-32 Radiologic Findings in Limb-Salvage
Procedures, 268
6-33 Limb-Salvage Procedures, 269
SECTION 7—INJURY TO
MUSCULOSKELETAL SYSTEM
7-1 Closed Soft Tissue Injuries, 272
7-2 Open Soft Tissue Wounds, 273
7-3 Treatment of Open Soft Tissue
Wounds, 274
7-4 Pressure Ulcers, 275
7-5 Excision of Deep Pressure Ulcer, 276
7-6 Classification of Burns, 277
7-7 Causes and Clinical Types of Burns, 278
7-8 Escharotomy for Burns, 279
7-9 Prevention of Infection in Burn
Wounds, 280
7-10 Metabolic and Systemic Effects of
Burns, 281
7-11 Excision and Grafting for Burns, 282
7-12 Etiology of Compartment Syndrome, 283
7-13 Pathophysiology of Compartment and
Crush Syndromes, 284
7-14 Acute Anterior Compartment
Syndrome, 285
7-15 Measurement of Intracompartmental
Pressure, 286
7-16 Incisions for Compartment Syndrome of
Forearm and Hand, 287
7-17 Incisions for Compartment Syndrome of
Leg, 288
7-18 Healing of Incised, Sutured Skin
Wound, 289
7-19 Healing of Excised Skin
Wound, 290
7-20 Types of Joint Injury, 291
7-21 Classification of Fracture, 292
7-22 Types of Displacement, 293
7-23 Types of Fracture, 294
7-24 Healing of Fracture, 295
7-25 Primary Union, 296
7-26 Factors That Promote or Delay Bone
Healing, 297
SECTION 8—SOFT TISSUE INFECTIONS
8-1 Septic Joint, 300
8-2 Etiology and Prevalence of Hematogenous
Osteomyelitis, 301
8-3 Pathogenesis of Hematogenous
Osteomyelitis, 302
8-4 Clinical Manifestations of Hematogenous
Osteomyelitis, 303
8-5 Direct (Nonhematogenous) Causes of
Osteomyelitis, 304
8-6 Direct (Nonhematogenous) Causes of
Osteomyelitis (Continued), 305
8-7 Osteomyelitis after Open Fracture, 306
8-8 Recurrent Postoperative
Osteomyelitis, 307
8-9 Delayed Posttraumatic Osteomyelitis in
Diabetic Patient, 308
SECTION 9—COMPLICATIONS
OF FRACTURE
9-1 Neurovascular Injury, 310
9-2 Adult Respiratory Distress
Syndrome, 311
9-3 Infection, 312
9-4 Surgical Management of Open
Fractures, 313
9-5 Gas Gangrene, 314
9-6 Implant Failure, 315
9-7 Malunion of Fracture, 316
9-8 Growth Deformity, 317
9-9 Posttraumatic Osteoarthritis, 318
9-10 Osteonecrosis, 319
9-11 Joint Stiffness, 320
9-12 Complex Regional Pain Syndrome, 321
9-13 Nonunion of Fracture, 322
9-14 Surgical Management of Nonunion, 323
9-15 Electric Stimulation of Bone Growth, 324
9-16 Noninvasive Coupling Methods of Electric
Stimulation of Bone, 325
Llamanos al
