Question on a patient with Osteoporosis

Scenario: The patient is a 72-year-old woman who is having mid-thoracic pain after a coughing bout. The patient is having a dull ache pain that is constant. Upon X-rays, thoracic compression fractures are found. The patient received kyphoplasty surgery. Physical therapy treatment followed by progressive weight-bearing exercises.

Question: Besides constant dull aching pain, what are some other common signs and symptoms of osteoporosis used for diagnosis?

A. Low BMD, swelling in small joints, acute pain in small muscles, postural deformities

B. Low BMD, multiple fractures, loss of height, spinal deformations

C. Multiple fractures, pain and stiffness, hypermobility in large joints

D. Spinal deformations, low BMD, hypermobility of small joints, acute pain in small muscles

Answer with rationale: B. Low BMD, multiple fractures, loss of height, spinal deformations. Low BMD comes from… Often patients with osteoporosis will first present with a fracture or fractures and can be asymptomatic for pain. Due to bone degeneration and compression in the vertebral column, the patient may present with loss of height. Spinal deformations are common due to degeneration and destruction of bone.

For more information see Chapter 135: Osteoporosis in The Color Atlas of Physical Therapy