A 70-year-old man is brought to the doctor having a sudden onset of severe lower back pain. Upon conducting a physical examination of the patient, severe kyphosis is revealed. An x-ray of the back shows a compression fracture in the lumbar area of a vertebral body. This is followed by marked thinning of the bones as well. Laboratory tests measuring serum calcium, alkaline phosphatase, phosphorus, and parathyroid hormone levels, all come back within the normal range.
What is the most likely reason behind the bone changes in the patient?
A- Osteitis fibrosa cystica
The likely diagnosis for the patient is osteoporosis. This is a condition wherein the bones become fragile and have a higher risk of fracture. In a normal human being, the bone mass or density starts decreasing after 35 years of age. Lack of calcium, vitamin D, exercise, as well as genetics, can increase the risk of having osteoporosis. The diagnosis of osteoporosis can be confirmed by x-rays and tests for measuring bone density. Osteitis fibrosa cystica is a common complication of hyperparathyroidism. Serum calcium and parathyroid hormone should be high which is not the case in this patient.
The correct answer is B