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-Schoenberg 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 Behcet Syndrome, 232 5-62 Behcet 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
