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Hormonale Osteopathien im Erwachsenenalter

  • Susanne Bosnjakovic-Büscher
  • H. Ellegast
  • F. Heuck
  • H. W. Schneider
Chapter
Part of the Handbuch der Medizinischen Radiologie / Encyclopedia of Medical Radiology book series (HDBRADIOL)

Zusammenfassung

Zahlreiche Erkrankungen und äußere Einwirkungen sowie metabolische und hormonale Faktoren wirken auf das Skelett als biologische Einheit, das nicht nur stützende und blutbildende Funktion hat, sondern als Organ des Stoffwechsels ein großes Mineraldepot darstellt, das vorwiegend Kalzium, Phosphat und Karbonat enthält. Durch seinen hohen Kalksalzgehalt ist der Knochen als einziges Gewebe des Körpers ohne Hilfsmittel mit konventionellen Röntgenuntersuchungsmethoden gut zu beurteilen. Seit Anfang der sechziger Jahre kommen zunehmend quantitative radiologische Untersuchungsmethoden zur Anwendung, die einmal der Erkennung mikro- und makromorphologischer Strukturveränderungen und zum anderen der Erfassung von Änderungen des Kalksalzgehaltes im Knochen dienen. Daß die generalisiert auftretenden Umbauprozesse in verschiedenen Skelettabschnitten in unterschiedlichem Maße in Erscheinung treten, hängt von der Hämodynamik der Knochendurchblutung, von der physiologischen Knochenumbaurate und von den statischen Kräften in dem einzelnen Knochen als Bauelementen des Stützgerüstes ab. Die einzelnen Faktoren, die den ständigen Knochenumbau und damit die Struktur und die Zusammensetzung des Knochens kontrollieren, sind noch weitgehend unbekannt (VAUGHAN 1975). Als gesichert gilt, daß von den bekannten inneren Regulationsmechanismen das Wachstumhormon, das Schilddrüsenhormon und die adrenokortikalen Androgene den Knochenstoffwechsel, die Nebenschilddrüsenhormone, Vitamin-D-Metaboliten und Kalzitonin den Mineralstoffwechsel regulieren. Da der Knochen als Mineraldepot dient, wirken sich Störungen des Kalziumstoffwechsels auf die Mineralisation des Knochens aus. Vitamin A und Vitamin C greifen ebenfalls in den Knochenstoffwechsel ein. Eine große Rolle in der physiologischen Knochentransformation scheint das Kalzitonin, welches die Knochenresorption hemmt, zu spielen.

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