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Osteoporosis investigation — SCE Rheumatology MCQ

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EasyMetabolic Bone DiseaseOsteoporosis investigationSCE Rheumatology

A 66-year-old woman is assessed after a low-trauma vertebral fracture. She has no cancer history and takes no glucocorticoids. Calcium, phosphate, ALP, FBC, renal function and thyroid function are requested as part of secondary cause assessment. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — DEXA scan with fracture risk assessment

Explanation lettering: E = shown as A · D = shown as C · A = shown as D · C = shown as E

DEXA scan with fracture risk assessment is best because DEXA with fracture risk assessment helps define osteoporosis severity and treatment decisions after fragility fracture. A is less suitable because temporal ultrasound assesses GCA; C is less suitable because ANCA assesses vasculitis; D is less suitable because MRI sacroiliac joints assesses axial SpA; E is less suitable because serum urate during a flare assesses gout but is unrelated. Clinical pearl: secondary cause tests and fracture risk tools complement rather than replace each other.

Reference: NOGG osteoporosis guideline; NICE CG146