MSK viva

Question 1

Osteoporosis

1. Positive findings
2. Negative findings
3. RF
4. Investigations
5. Management
6. DD

Answer 1

1. Positive findings
   - Repeated fractures
   - Kyphosis
2. Negative findings
   - No stiffness
3. RF
   “SHATTERED”
4. Investigations
   Bedside: FRAX score
   Bloods: Ca2+, phosphate, ALP
   Imaging: DEXA scan (less than -2.5), X-ray
5. Management
   Conservative: Stop smoking, weight bearing exercise, healthy weight, diet
   Medical: Bisphosphonates + Calcium and vit D supplements&raquo_space; Denosumab» HRT
6. DD
   - Multiple myeloma
   - Osteomalacia