Case Study Osteoporosis
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Tarrant County College, Fort Worth *
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Course
2208
Subject
Medicine
Date
Feb 20, 2024
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doc
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2
Uploaded by pbansu07
Name:_______________________________________
Case Study: Osteoporosis
A&P I
Chief Complaint:
72-year-old woman who fell on her right hip.
History:
Margaret Donovan, a 72-year-old white female, was brought to the emergency room
by her son-in-law after falling in her bathtub. She was previously in good health, despite leading a relatively sedentary lifestyle and having a history of cigarette smoking. The only medication she currently takes is Inderal (propranolol) for mild hypertension. She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. There was no trauma to her head, nor does she complain of right or left wrist pain. However, she reports severe pain in the right hip and upper thigh, and was unable to get up after her fall. An injection of oxymorphone hydrochloride (Numorphan) helped relieve her pain
and she was taken to the radiology department for an X-ray of her right leg and hip.
Physical Examination:
The patient was alert, oriented to time, place, and date, and was responding appropriately to questions despite being in considerable pain. There were no signs of trauma to the head, neck, torso, arms, or left leg. The right thigh and hip were extremely tender and were immobilized by a leg splint. Heart and lung sounds were normal, and abdominal sounds were reduced.
Radiology Report:
The X-ray of the right hip revealed a complete, comminuted, intertrochanteric fracture of the right hip. No other fractures were noted in the right leg. There were also long-term osteoporotic changes in the femur, tibia, and fibula.
Following her recovery, Margaret was placed on three medications: (A) oral calcium supplementation, (B) oral estrogen, and (C) oral alendronate sodium (Fosamax). Specifically describe how each of these medications works to treat Margaret's condition.
Questions
:
1.
The radiologist reported signs of osteoporosis. Describe the characteristics of an osteoporotic femur as seen on an X-ray. (How does it differ in appearance from a normal femur?)
Osteoporosis is marked in an x-ray by a decrease volume in bone. The loss of compact bone is more than of the spongy bone. 2.
Describe the microscopic features of osseous tissue that normally help long bones withstand lateral stress without breaking.
A lateral stress placed on a bone causes compression of the bone on the side of the bone that receives impact compresses because of its bony collar and extracellular Due October 16th
matrix
and the opposite side stretches instead of tearing because of the vertically and spirally
arranged bundles of collagen. Due to this they cancel each other out.
3.
Describe the microscopic features of osseous tissue that normally help long bones withstand compressive stress without breaking.
The bony collar of long bones help them withstand compressive stress by hydroxyapatite, weight-bearing pillars. Another thing that helps them withstand the compressive stress is the spongy bone in the epiphyses. The interlocking network of trabeculae found in the spongy bone help distribute the body’s weight out to the tough bony collar of the diaphysis.
4.
During her long recovery, Margaret is advised by her physician to begin weight-
bearing as soon as she can. How does weight-bearing influence the bone? 5.
What risk factors does Margaret have for osteoporosis?
Margaret have several risk factors for osteoporosis; firstly, she is elderly and osteoporosis is more common in the elderly and postmenopausal women. Secondly, she is a smoker. Moreover, she is Caucasian. It is a known fact that osteoporosis is more common in Caucasian than in person of other races. Lastly, she is sedentary meaning she doesn’t exercise. There are other potential risk factors for osteoporosis including: decreased bone mass, testosterone depletion, calcium deficiency, estrogen depletion and alcohol abuse.
6.
What parts of the skeleton (i.e. what bones) are most vulnerable to the ravages of osteoporosis?
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