Skeletal Case Study
Name: ___________________________________ Period: _____ Date: ___________
Case Study: Skeletal System
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 30-year history of cigarette smoking. The only medication she currently takes is Inderal (propranolol) for mild hypertension (high blood pressure). 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 (top part of the femur) 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.
Questions
1. What is meant by a “complete, comminuted, intertrochanteric fracture of the right hip?”
2. Draw a picture of what you think Margaret’s fractured femur looks like.
3. The radiologist reports signs of osteoporosis. How is osteoporotic bone different from regular bone?
4. Why do bones become osteoporotic in
Case Study: Skeletal System
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 30-year history of cigarette smoking. The only medication she currently takes is Inderal (propranolol) for mild hypertension (high blood pressure). 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 (top part of the femur) 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.
Questions
1. What is meant by a “complete, comminuted, intertrochanteric fracture of the right hip?”
2. Draw a picture of what you think Margaret’s fractured femur looks like.
3. The radiologist reports signs of osteoporosis. How is osteoporotic bone different from regular bone?
4. Why do bones become osteoporotic in