Chapter 8
1. The emergency room physician suspects osteoporosis because Susan is
postmenopausal, a risk factor for osteoporosis. On the other hand, the fact that Susan is
physically active makes her less likely to have osteoporosis and leads to the possibility
that bone cancer could have weakened her hip bone and led to the fracture.
2. If Susan had bone cancer, the scans would have revealed the presence of a tumor, such
as an osteosarcoma, chondrosarcoma, fibrosarcoma, or myeloma. The bone density
scan would have revealed local changes in bone density associated with a tumor rather
than the overall decrease in bone density characteristic of osteoporosis.
3. Vitamin D is needed for the proper absorption of dietary calcium. Although the body
produces vitamin D on its own, the goal of treatment in Susan’s case is to maximize her
calcium absorption by having her take supplementary vitamin D.
4. Susan’s fracture is nondisplaced, meaning that the portions of the bone remain in the
correct anatomical alignment with each other, and oblique, meaning that the fracture is
diagonal.
5. Osteomyelitis developed after Susan’s surgery. Characteristic signs and symptoms
observed in Susan include fever, swollen lymph nodes, elevated lymphocyte count, and
redness, inflammation, edema, and increased pain at the surgical site. The diagnosis of
osteomyelitis is confirmed by the observation of a subperiosteal abscess through a CT
scan.
6. In all likelihood, Susan’s case is one of exogenous osteomyelitis, a bacterial bone
infection introduced during the open reduction of her hip fracture. Bacteria might have
been introduced by way of imperfectly sterilized screws inserted to internally fix the
femur or by other contamination of the surgical field.
7. John has a better prognosis than Marvin because chondrosarcomas can only be
successfully removed by amputating the affected bone. Amputation of the lower leg is
possible, but amputation of the pelvic bones is not possible.
8. A bone tumor predisposes a bone to pathological fracture because the tumor weakens
the bone, making it more likely to break. Bones are also weakened by other diseases,
such as osteoporosis. A stress fracture is not caused by disease but by severe trauma to
a bone such as a hard fall or a blow.
9. Unlike the skin and other superficial body structures, bone cannot be directly observed
during a routine physical examination. Palpation can be used to determine gross bone
abnormalities and some fractures, but it is not as useful for discerning bone cancers,
osteoporosis, osteomyelitis, or the different types of fractures. Imaging techniques
enable a clinician to view the bone and determine whether abnormalities are present.
10. Osteochondroses are most prevalent in children because their bones are still growing.
Adult bones do not have ossification centers that could be affected by osteochondrosis.