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Radiology Musculoskeletal Radiology e5ce4331

A 69-year-old female presents with the recent onset of mild back pain. Otherwise she has no other pains and quite good in her daily activities and active in her NGO field activities. Physical examination reveals kyphosis, while an x-ray of her back reveals a compression fracture of a veebral body in the dorsal spine, with spondylotic changes and mildly reduced bone denisty. Serum calcium, phosphorus, alkaline phosphatase, ESR and parathyroid hormone levels are all within normal limits. This woman's bone changes are most likely due to

A
Myeloma
B
Osteoporosis
C
Osteomalacia
D
Paget's disease
High-Yield Explanation
This post-menopausal old female has osteoporosis with wedge fracture if dorsal veebra. Serum calcium, phosphorus, alkaline phosphatase, and parathyroid hormone levels are all within normal limits, ruling out the possibility of paget's disease, hyperparathyroidism and osteomalacia. Osteoporosis Reduction in the strength of bone that leads to an increased risk of fractures. Loss of bone tissue is associated with deterioration in skeletal microarchitecture. The WHO operationally defines osteoporosis as a bone density that falls 2.5 standard detions (SD) below the mean for young healthy adults of the same sex--also referred to as a T-score of -2.5. Postmenopausal women who fall at the lower end of the young normal range (a T-score <-1.0) are defined as having low bone density and are also at increased risk of osteoporosis. Myeloma can masquerade as generalized osteoporosis, characteristic "punched-out" lesions on radiography. Serum and urine electrophoresis and or serum free light chains are required to exclude this diagnosis.

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