SKELETAL SYSTEM: OSTEOPOROSIS
Margaret Donovan, a 72-year-old white female, was brought to the emergency room after falling in her bathtub. She was previously in good health, despite leading a relatively sedentary lifestyle and having a 30-pack-year history of cigarette smoking. The only medication she currently takes is for mild hypertension. She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. 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 helped relieve her pain.
Physical Examination: The right thigh and hip were extremely tender and were immobilized by a leg splint.
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.
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Questions:
- What is meant by a “complete, comminuted, intertrochanteric fracture of the right hip”?
- 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?)
- Describe the changes (steps) that a broken bone undergoes as it is healing.
- 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 process? (Be specific in your answer and describe what weight-bearing does to bone at the microscopic level.)
- Why Margaret’s physician want her to avoid a prolonged period of bed-ridden inactivity? Why astronauts find loss in bone volume upon their return to earth?
- What risk factors does Margaret have for osteoporosis?
- Which part of the skeletal system is affected more by osteoporosis?
