The Netter Collection of Medical Illustrations: Musculoskeletal System, Volume 6, Part III - Biology and Systemic Diseases, 2nd Edition

The Netter Collection of Medical Illustrations: Musculoskeletal System, Volume 6, Part III - Biology and Systemic Diseases

2nd Edition

By Joseph P Iannotti, M.D., Ph.D. , Chairman, Orthopaedic and Rheumatologic Institute The Cleveland Clinic and Richard Parker, M.D., Chairman, Department of Orthopaedic Surgery, Cleveland Clinic


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