Guided Case Study
1. What symptoms does Mr. Thompson have?
Your elderly neighbor, Fletcher Thompson, has been complaining of
pain in his right leg for the past few months. You finally convince
him to see a doctor, who recommends an X-ray. Upon looking at
the X-rays, the doctor also orders a blood test. The results show
high levels of alkaline phosphatase, an enzyme that aids in the
mineralization of new tissue.
2. How do high levels of alkaline phosphatase indicate a bone
abnormality?
3. What bones are often affected by Paget's disease? (Give at
least 4
Case Study #4: Bone Breakdown
4. What are the functions of osteoblasts and osteoclasts in the
formation of bone?
The doctor diagnoses Mr. Thompson with osteitis deformans, more
commonly known as Paget's disease of the bone. Paget's disease is
common in the middle-aged population and is often asymptomatic.
It causes the body to regenerate bone more often and faster than
normal, resulting in bones that have a disorganized structure and
reduced strength. This can lead to bone pain, deformities, and
fractures. The affected bones are usually localized, but are most
often in the axial skeleton and the long bones of the legs.
5. The incidence rate of Paget's disease is luighest in the elderly
population and seems to be less prevalent in younger
populations. Does this indicate a genetic or envirotinental
cause? Explain
Individuals with Paget's disease have overactive osteoblasts (botte
building cells) and osteoclasts (bone-killing cells), causing a process
called dysregulation, which eventually distorts the normal skeletal
ture. The cause of Paget's disease is still unknown, but there
are liypotheses that it could have a genetic component and
environmental causes.
6: Some individuals are able to tolerate bisphosphonates well
Doctors sometimes prescribe a natural hormone that has similar
properties. What do you suppose it is? (Hint: It is normally
secreted by the thyroid gland.)
Although there is no cure for Paget's disease, there are treatments
that can alter the bone regeneration process. Besplosphonates (also
commonly prescribed for osteoporosis) reduce osteoclast activity