Broken 2

Musculoskeletal System


Step 1: View Clinicals

{"ops":[{"insert":"A 45-year-old woman presents with dull back pain, which started suddenly three days ago, and has since worsened. The pain is exacerbated by movement. There is no history of trauma or lifting heavy weights.\n\nShe was diagnosed with moderate persistent asthma around 10 years ago and prescribed inhaled salmeterol and fluticasone. However, she has shown poor compliance and has experienced frequent exacerbations, which were often treated with oral prednisolone.\n\nShe is physically active and does not smoke or consume alcohol. She continues to have regular menstrual cycles. Her family history is unremarkable.\n\nSpinal x-rays reveal a compression fracture of the second lumbar vertebra, while the entire spine appears mildly osteopenic. A complete blood count, liver profile, renal profile, HbA1c, ESR, and CRP are all found to be normal.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-227_en.png"}},{"insert":"\n"}]}

Step 2: Order Relevant Investigations

1. Dual energy X-ray absorptiometry
2. 25-OH vitamin D levels
3. Serum Calcium + Phosphorus
4. Iliac crest bone biopsy

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