Assignment: Disorders of Musculoskeletal Function Assignment: Disorders of

Assignment: Disorders of Musculoskeletal Function

Assignment: Disorders of Musculoskeletal Function

Case Study 3

Disorders of Musculoskeletal Function: Developmental and Metabolic Disorders

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Mandy is a 16-year-old competitive figure skater who practices several hours a day with her coach at the skating arena. Because of her extremely active lifestyle and restricted diet to maintain her athletic physique, she experiences ongoing amenorrhea. One day during practice, she landed a jump and fell to the ice in pain. Her left foot swelled up almost immediately, making it difficult for her coach to remove the skate. At the hospital, radiographs revealed a fracture of the fifth metatarsal bone and general radiolucency of all the bones in her foot. A follow-up DXA revealed a bone mass of 2.7 standard deviations below mean.

1. What is the etiology of Mandy’s premature osteoporosis, and how her condition is thought to contribute to a decrease in bone density?
2. Knowing what you do about bone mineralization, why does a deficiency of estrogen in women lead to osteoporotic change?
3. Osteoporosis and osteomalacia both involve abnormal bone mineralization. What are the general macroscopic differences of these two conditions?

Case Study 4

Disorders of Musculoskeletal Function: Rheumatic Disorders

Rick is a 27-year-old who works in an accounting firm. He had started to experience lower back pain and stiffness that he thought were a result of the long hours he spent at his desk. More recently, however, he began to have sleep difficulties. He found that he often woke up during the night feeling hot and sometimes sweaty. Furthermore, his back pain disrupted his sleep, particularly when it radiated around his pelvis and into his thighs. When his lack of sleep began to interfere with his work, he went to an osteopath to see what was wrong. She listened to his case history carefully. Upon physical examination, she noted a slight decrease in his lumbar lordosis and a reduced range of movement in his lumbar spine. His blood tests revealed the presence of HLA-B27, an elevated ESR, and absence of RH. His radiograph showed evidence of sacroiliitis.

1. What is the likely diagnosis Rick received? What are the common clinical presentation and manifestations of the disease?
2. Why is osteoarthritis of the hips a potential secondary complication of this disease? What are the structural changes that occur in the articular cartilage of an osteoarthritic joint?
3. What is the effect of advanced ankylosing spondylitis on lung function?

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