A 46-year-old woman with severe asthma presents with increasing weight and back pain for 9 months. The patient is taking coicosteroids for her asthma. An X-ray of the veebrae will likely reveal which of the following pathologic findings?
**Core Concept**
Asteroid bodies are a characteristic histopathological feature of osteonecrosis, also known as avascular necrosis (AVN) of bone, which can be caused by long-term corticosteroid use. This condition involves the death of bone tissue due to impaired blood supply.
**Why the Correct Answer is Right**
The patient's prolonged use of corticosteroids for asthma management is a risk factor for developing osteonecrosis of the vertebrae. Corticosteroids can lead to impaired bone metabolism, increased bone resorption, and reduced bone density, making the vertebrae more susceptible to AVN. The characteristic histopathological feature of AVN is the presence of asteroid bodies, which are calcified, star-shaped structures within the osteocytes.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because osteoporosis, while related to corticosteroid use, does not typically present with asteroid bodies. Osteoporosis involves decreased bone density, but it does not involve the characteristic histopathological changes seen in osteonecrosis.
**Option B:** This option is incorrect because vertebral fractures, while possible in osteoporosis, are not specific to corticosteroid use and do not involve asteroid bodies.
**Option C:** This option is incorrect because vertebral disc degeneration is a common age-related change and is not directly related to corticosteroid use or asteroid bodies.
**Option D:** This option is incorrect because vertebral hemangioma is a benign vascular lesion that can present with back pain, but it does not involve asteroid bodies.
**Clinical Pearl / High-Yield Fact**
Long-term corticosteroid use can lead to osteonecrosis of the vertebrae, which can present with back pain and weight gain. This is an important consideration in patients with chronic asthma or other conditions requiring prolonged corticosteroid therapy.
**Correct Answer:** C.