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Osteoporosis — SCE Rheumatology MCQ

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EasyMetabolic bone diseaseOsteoporosisSCE Rheumatology

A 69-year-old woman has a low-trauma distal radius fracture and height loss. Examination shows there is thoracic kyphosis without focal neurological signs. Investigations show DXA shows a femoral neck T-score of -2.8. The admitting team asks which diagnosis best explains the whole presentation. What is the most likely diagnosis?

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Correct answer: D — Osteoporosis

Osteoporosis is the best answer because the pattern described is most consistent with Osteoporosis, including the distribution of symptoms and the targeted investigation results. Granulomatosis with polyangiitis is a plausible distractor, but it does not account for the key discriminator in the stem. Reactive arthritis and Rotator cuff tendinopathy would be more appropriate in a different clinical pattern or at another point in the pathway, while Hydroxychloroquine retinopathy is suboptimal for this presentation. Clinical pearl: in SCE-style questions, the decisive clue is usually the pattern across joints, extra-articular features and targeted immunology rather than a single antibody result.

Reference: NICE CG146; NOGG guideline; BNF