Disorders of the musculoskeletal system cut a wide path across all categories and types of injury. For example vascular and neurological conditions can directly affect muscular activity and strength. Moreover, it's often difficult, at least initially, to distinguish underlying causes of progressive muscular weakness, and occasionally a muscle or even peripheral nerve biopsy is called for. In other situations, serum antibody studies prove helpful in making a particular diagnosis. But always, the diagnostic process begins with the history and physical exam.

In this unit we will be looking at a number of categories of disease with either primary or significant secondary effects on the muscular system, bone and/or connective tissue. In some situations the causation may be straight forward, whereas in others the mechanism of injury and development of the disease will be baffling. A case in point is myositis ossificans. Here we will see an example of fully developed benign bone forming at a site of injury either in soft tissue or skeletal muscle. Very peculiar. We will also study examples of primary inflammatory states, as well as malignancies, of the skeletal muscle and soft tissues. Even though we may not review a case of every type of injury or disease, remember the musculoskeletal system can suffer from each of the major divisions of injury. Here are a few that are representative of all.
   

Slide 7, healing fracture of bone.	Slide 23, metastatic transition cell carcinoma in bone marrow.	Slide 49, bone marrow hyperplasia.	Slide 88, infarction of omental fat.	Slide 121, myositis.
Slide 125, fibrosarcoma of bone.	Slide 134, myositis osificans	Slide 156, dermatofibrosarcoma protuberans	Slide 165, bone marrow with cryptococcus infection.	Slide 166, bone marrow with cryptococcus, stained using the Gomori's Methenamine Silver technique.
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Normal, hyperplastic and hypoplastic bone marrow all on one slide for comparison.	Normal decalcified bone section	Normal skeletal muscle	Musculoskeletal Side Overview

Mark Braun, MD braunm@indiana.edu
Copyright 1998, the Trustees of Indiana University