QuestionSBA
QuestionChoice
The patient's T-score of -1.7 represents a diagnosis of osteopenia. Osteopenia is diagnosed with T-scores between -1 and -2.5. The patient has a reduction in her bone density 1.7 standard deviations below the young adult mean value, which puts her at an increased risk for fractures. If her bone density continues to fall, she may eventually be classed as having osteoporosis.
10006766
a
Osteopenia
QuestionChoice
This is a bone remodelling disorder comprised of increased bone resorption followed by the formation of new weaker bone, increased blood flow and fibrous tissue. It is common in older adults, and may be asymptomatic or present with bone and joint pain, specific bone deformities and bony changes on X-ray.
10006770
e
Paget's disease
QuestionChoice
Osteomalacia is caused by a severe vitamin D deficiency, causing inadequate mineralisation of bones. These patients have soft bones causing rickets in children and osteomalacia in adults following epiphyseal closure. Although low bone density can be a manifestation of osteomalacia, patients are often asymptomatic. Severe vitamin D deficiency would be the hallmark of this condition, which is not present in this patient.
10006767
b
Osteomalacia
QuestionChoice
The most common presenting complaint for patients suffering from myeloma is back pain. The key clinical features can be remembered using the mnemonic CRAB (hyperCalcaemia, Renal impairment, Anaemia, Bone lesions). This is a neoplastic proliferation of plasma cells within the bone marrow and may present with fractures. However deranged blood tests including hypercalcaemia, evidence of renal impairment, and urinary Bence-Jones protein would be expected.
10006769
d
Multiple myeloma
QuestionChoice
Osteoporosis is likely to present very similar to osteopenia, but a diagnosis is only made following a T-score lower than or equal to -2.5. This score represents a bone mass density more than 2.5 standard deviations below the young adult mean value. This puts individuals at high risk of developing fractures without any major trauma, and represents a more severe version of osteopenia.
10006768
c
Osteoporosis
QuestionComment
Wasn't her fall on the way to the bathroom a fragility fracture. So shouldn't she automatically have osteoporosis?
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Epidermis Lung
Concept
Chapter
2693
4476
Osteoporosis
Topic
145
Orthopaedics
13900
An 82-year-old female inpatient on the diabetes and endocrine ward falls after going to the toilet and suffers a fractured hip. A DEXA scan is ordered for the patient which gives a T-score of -1.7. An X-ray of her hip shows reduced bone trabecular bone density. She has no past medical history of any fractures other than a broken leg at the age of 24. The patient's serum vitamin D and calcium are within normal ranges and she denies any pain other than in her hip.

What is the most likely underlying cause for the patient's hip fracture?
a