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Osteoporosis — ABIM Board MCQ

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ModerateEndocrinology/MetabolismOsteoporosisABIM Board

A 72-year-old woman sustains a low-trauma distal-radius fracture after a fall from standing height. The fracture is treated and she has never undergone skeletal evaluation. What is the most appropriate next investigation?

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Correct answer: E — Arrange central DXA as part of osteoporosis and secondary-cause evaluation

The best answer is “Arrange central DXA as part of osteoporosis and secondary-cause evaluation”. A fragility fracture after age 50 is a sentinel event requiring osteoporosis evaluation; central DXA quantifies bone mineral density and helps guide treatment and monitoring. A normal serum calcium would not exclude osteoporosis. Bone scan and sestamibi answer different diagnostic questions, and waiting for another fracture misses an opportunity for secondary prevention.

Reference: Bone Health and Osteoporosis Foundation 2022 Clinician Guide: https://pubmed.ncbi.nlm.nih.gov/35478046/