Musculoskeletal System

Step 1: View Clinicals

{"ops":[{"insert":"A 22-year-old woman is referred for further evaluation of a fractured left femur, sustained after she slipped and fell on a flat floor yesterday. X-rays showed a transverse subtrochanteric fracture, with markedly dense cortical boundaries and a reduced intramedullary diameter.\n\nHer medical and surgical histories are unremarkable, and she is not on any medications. Her mother experienced a foot fracture and a Colles fracture at the ages of 32 and 55 years respectively. These were treated individually, without further evaluation.\n\nShe is a student at the local community college, has never smoked, and only drinks socially.\n\nA complete blood count is significant for a Hb of 10.5 g\/dL (normal: 12-18), with normal MCV, MCH and MCHC values. Peripheral smears confirm normochromic normocytic anemia. A reticulocyte count is 0.5% (normal: 0.5-1.5).\n\nHer ESR, CRP, and renal and liver profiles (including serum alkaline phosphatase levels) are all within normal parameters.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-S-086_en.png"}},{"insert":"\n"}]}

Step 2: Order Relevant Investigations

1. Serum TSH and PTH
2. Skeletal survey
3. Serum tartrate-resistant acid phosphate
4. Transiliac bone biopsy

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