196 Anatomy, Histology, and Cell Biology
A(A. Reproduced, with permission, from Erlandsen SL , Magney JE:Color Atlas of Histology.
St. Louis, MO: CV Mosby, 1992.)
108.A 22-year-old man presents to the orthopedic clinic after a referral from
his primary care physician. He has a history of recurrent fractures of the
humerus and femur and numerous dental caries and associated abcesses.
Three years prior to this referral, he was successfully treated with hyperbaric
oxygen and surgery for mandibular and maxillary osteomyelitis. Laboratory
results include a serum acid phosphatase of 4 units (0.5–2 is normal range by
the Bodanksy method) and a hematocrit of 35 (normal range is 41–50%,
mean is 47%). Other blood tests are normal. He complains of joint pain. A
spine x-ray shows “sandwich” vertebrae with thickening of the vertebral end-
plates. X-rays of the long bones show abnormal thickening of the bone. A
skull x-ray shows basilar sclerosis. The cell type primarily affected in this
patient is shown in the accompanying transmission electron micrograph (A)
and labeled as “C” in the light micrograph (B). The activation and stimulation
of those cells is involved in which of the following?