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Osteoporosis — SCE Rheumatology MCQ

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HardMetabolic bone diseaseOsteoporosisSCE Rheumatology

A 58-year-old has a low-trauma distal-radius fracture, height loss and a femoral-neck T-score of −2.8. Which additional investigation should be considered because occult vertebral fracture would change risk stratification?

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

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Correct answer: B — Vertebral fracture assessment or lateral spine imaging

The best answer is “Vertebral fracture assessment or lateral spine imaging”. Height loss and kyphosis in a patient with osteoporosis should prompt vertebral imaging or DXA vertebral-fracture assessment because an unrecognised vertebral fracture materially alters future fracture risk. The remaining choices—“Repeat DXA immediately on a second machine”, “Whole-body PET-CT, after safety review”, “Bone marrow biopsy, after specialist assessment”, “Temporal artery ultrasound, with clinical reassessment”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

Reference: NOGG full clinical guideline: https://www.nogg.org.uk/full-guideline