Osteoporosis
An 82-year-old woman presented to the clinic after a recent fall in her home, resulting in a fracture of her left wrist. She reported minimal trauma during the fall but
experienced immediate pain and swelling in the wrist. The fracture was confirmed by X-ray, and she was referred for further evaluation due to concerns about bone health.
The patient had a history of occasional back pain but had not experienced any prior fractures. She reported a decrease in her height over the past few years and had
noticed a stooped posture. Her medical history included hypertension and mild osteoarthritis, managed with medication. She had been postmenopausal for over 30
years and had not been on any hormone replacement therapy. There was no significant family history of osteoporosis or fractures.
A bone mineral density (BMD) scan revealed a T-score of -3.0 at the lumbar spine and -2.8 at the hip, consistent with a diagnosis of osteoporosis. Routine blood tests,
including calcium and vitamin D levels, were normal, but she was found to have low bone density.
The physician explained the diagnosis of osteoporosis and discussed lifestyle modifications, including increasing calcium and vitamin D intake, weight-bearing exercises, and fall prevention strategies. Pharmacological treatment with a bisphosphonate was recommended to reduce the risk of future fractures. The patient was also advised to undergo regular monitoring of her bone density and return for follow-up in six months.
a) Severe back pain
b) Difficulty walking
c) A fall resulting in a wrist fracture
d) Sudden onset of joint pain
a) -1.0
b) -2.5
c) -3.0
d) -2.0
a) Hormone replacement therapy
b) Corticosteroids
c) Bisphosphonate therapy
d) Surgery for spinal correction
a) Reduce physical activity
b) Increase calcium and vitamin D intake
c) Avoid sunlight
d) Stop all medications
Answers
1. c) A fall resulting in a wrist fracture
2. c) -3.0
3. c) Bisphosphonate therapy
4. b) Increase calcium and vitamin D intake