Question

Mary-Lou’s family was happy with the management plan established by the doctor as Mary-Lou was progressing quite well. She was using notepads to jot down reminders, a pillbox to keep her medication organized and a calendar to record appointments. Her family members were helping her with routine tasks such as cooking and paying bills. She was feeling much happier and did not have to rely on alcohol to go to sleep. On one particular day she was feeling so good she decided to walk to her GP appointment alone. On her way there she stumbled over a branch and fell. She felt excruciating pain in her hip. A passer-by called an ambulance and she was taken to the emergency department at the Royal Melbourne hospital. An X-ray revealed that she had broken the neck of her femur and had to have surgery to repair it. Mary-Lou wondered whether this was linked to the crepitus she had been experiencing in her joints. Her joints did feel quite stiff and painful lately. The specialist explained to Mary-Lou that the crepitus was likely due to degeneration of her cartilage and said that the fracture might have been due to weakened bones. He told her he would like her to have a bone mineral density test to measure her bone density. The DEXA scan gave a T-score of -3.0. Mary-Lou is now given bisphosphonates and told to increase her daily intake of calcium.

Question: Discuss how the aetiology of Mary Lou’s joint disease differs from the other joint disease we covered in BIOL122.

Answer 1

Crepitus is the crackling sound caused by bones against each other. It is also known as creaky joints. Osteoarthritis and/or osteoporosis are the main cause of crepitus and in the above case Mary had this disease. She did not recognize it before nor had less consideration, because her physical movement was very short. But in one day when she decided to go for a walk, there she did some kind of physical activity. This resulted in the experience of symptoms of osteoporosis or crepitus. Osteoporosis means porous bone. When we view the osteoporosis bone under a microscope, it looks like honeycomb. Calcium is the main factor for bone structure. If we are deficient in calcium, there might be a greater chance to have fractures. The daily intake of calcium will help to strengthen her bones. Also, in women’s including in menopausal age group experiences osteoporosis. This is due to the decline in estrogen hormone during the menopause period causing woman’s bones to thin faster.