Case Studies II: The

Skeletal System

Case 1: The Case of the Abnormal

Bones
Jennifer has noticed that
her left clavicle and
left humerus have
been hurting chronically
for the last year.
Additionally, she noticed
that her clavicle has
grown to an abnormal
size. The doctors tested
her, and diagnosed her
with Pagets disease
of the bone.

Special note: People

with Pagets disease
of the bone may have
enlarged and
misshapen bones, or
brittle and fragile
bones. Unlike other
bone diseases, this
disease usually affects
only a few bones
within the system.

Question Set 1
Pagets disease of the bone affects
bone remodeling. Which two types of
cells are involved in bone remodeling?
In Jennifers case, her clavicle grew
abnormally large. What does this tell
you about the balance between her
osteoclast and osteoblast activity?

Question Set 2
Pagets disease of the
bone can be treated
with calcitonin in the
event that the bones
become brittle.

What is calcitonin?
What does calcitonin do
for a person with
Pagets disease?

Question Set 3
Abnormally high osteoclast activity is a major
factor in the remodeling of bone in Pagets
disease.

If you had to perform a blood test to confirm

this diagnosis, what would you look for in the
patient?
In rare cases, patients may develop
osteosarcoma. What is osteosarcoma?

Case 2: Leukemia Strikes

Mike was diagnosed
with leukemia at the
age of 9, and has been
waiting for a bone
marrow donor for the
past six months. The
doctors found a match
on the donor registry,
but further testing is
needed to ensure
compatibility.

Question Set 4
What are the Greek roots for the
word leukemia? Based on these
roots, what types of cells will be
affected?
Where are these cells formed?
What portion of the bone contains
bone marrow?

Question Set 5
Which bone do you think is usually
targeted for marrow donations?
Leukemia cells live longer than
normal cells. Why is this a problem?
What do cells need to live?

Case 3: The Human Weapon

The police responded to a call for a
disturbance at a nightclub in
Jacksonville. When they arrive, they
find two menone is awaiting the
police (and was involved in the fight),
the other is laid out after receiving
the most spectacular ***whooping of
his life. The police interview
witnesses for details.

Question Set 6
Police were informed that the guy who lost
the fight initiated the incident by hitting
the first guy in the head with a bottle.

What organ(s) are protected by the skull?

He was hit in the forehead. Which skull
bone is this, and why did it have little effect
on the person who was struck?

 The gentleman
who was hit is a
fifth degree black
belt in jiu-jitsu. He
responded to the
attack with a
punch to the ribs,
and then applied a
take-down and an
arm lock as shown.

Question Set 7
Which organs are
protected by the rib
cage? What might be
the outcome of a punch
to the ribs? (Hint: why
would this stun
someone?)
Which joint(s) are
immobilized by the arm
lock? What types of
joints are these?

Case 4: Rickets
A mother notices that her newborns
limbs are growing in a curved
fashion. Concerned, she takes her
child to the doctor, where she is told
that her child may have rickets.

Question Set 8
Rickets in children can lead to
deformities in skull development.
What type of bone development/formation
occurs in the skull bones? What are the
steps in bone formation?
Soft spots are also known as what? Why
are they necessary in newborns?

Question Set 9
Rickets can be
caused by a lack of
what dietary
component?
If a person is
albino, is there a
chance that they
may develop
rickets? Why or
why not?

Question Set 10
What do you think is a good
treatment for rickets?
Dietary?
Physical?