This is part of our House MD Project series.

Episode 21 of season 1, named “Three Stories” is not a usual episode. Instead of the usual one patient story (and the occasional clinic patients), this episode tells 3 short stories (as its name implies). Each patient presented with a different disease. Since this episode was presented differently, so will this article digress from the usual presentation. The 3 diseases on that episode will be covered here in brief.

Disease 1 – Necrotizing Fasciitis

This long name means simply an infection by what is known as the “flesh eating bacteria”.

On the House episode, a 40 year-old farmer arrives at the hospital claiming he was bit by a snake. After an anti-venom doesn’t help him and his leg’s muscles begin to rot, it is found out he was actually bitten by a dog, a bite that infected him with a germ called streptococcus.

We already covered necrotizing fasciitis in the past and you can read all about this disease here:

Necrotizing Fasciitis (Flesh Eating Bacteria) – Are You at Risk, and How You Can Avoid It

Disease 2 – Osteosarcoma

update: We now have a complete article about osteosarcoma, if you’re interested to know more details

The 2nd patient is a 16 year-old volleyball player arriving at the hospital after what seems like a strained ankle. After some trial and error it is found she has osteosarcoma, a cancer in the leg of thigh.

Osteosarcomas are the most common malignant bone cancer in children (along with a cancer named Ewing sarcoma). The cause is unknown. In the US, about 400 children and adolescents younger than 20 years old are diagnosed with osteosarcoma each year. It most commonly affects adolescents.

The disease presents with pain in a bony site. A mass may be palpable in the area as well. X-ray image of the area can discover the tumor. A biopsy from the area is needed to make sure it’s osteosarcoma.

An x-ray picture of an osteosarcoma of the arm. Photo by bc the path

Before chemotherapy, osteosarcoma used to be treated with amputation alone. Today chemotherapy is used along with surgery which can cut the tumor. Sometimes amputation is still needed, as was seen on House.

Disease 3 – Aneurysm

The 3rd patient is actually Dr. House himself, telling the story of how he got his leg pain to begin with. Turns out he had an aneurysm in the artery of his leg which wasn’t diagnosed on time, leading to blockage of blood to his leg’s muscles, which led to muscle death.

An aneurysm is a dilatation of an artery. The chances of getting it increase with age (it happens to at least 3% of people older than 50). Most aneurysms don’t cause any symptoms and go unnoticed. As they progressively enlarge, though, they may cause symptoms as a result of compression of the surrounding area, of clogging, sending a blood clot, or rupturing.

In the case of the House episode, his leg aneurysm clogged with a blood clot. This led to blood not arriving to his leg muscles, causing muscle death.

What next?

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