Q27: June 2020-2025 PLAB-UKMLA Exam Style Question

A 63 year old woman has fractured her left leg due to a fall in the bathroom. What is the diagnostic investigation to determine whether she has osteoporosis?

A. Spinal X-ray

B. CT bone

C. Calcium levels

D. DEXA scan

E. Bone marrow biopsy

Try to answer this question in 50 seconds. Comment your answer below . The answer to this question is given below.

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The correct answer is D .

• DEXA scan is the gold standard for diagnosing osteoporosis. Bone mineral density (g/cm2 ) is compared with that of a young healthy adult. It is better to scan the hip than the lumbar spine. A T-score of 0 to -1.5 points to no evidence of osteoporosis, score between -1.5 to -2.5 is considered to be osteopenic and a score of more than -2.5 is considered osteoporotic.

Why not A?

• Spinal X-rays are performed to diagnose the cause of back or neck pain, fractures or broken bones, arthritis, spondylolisthesis, degeneration of the discs, tumours, abnormalities in the curvature of the spine like kyphosis or scoliosis, or congenital abnormalities.

Why not B?

• A CT scan of the bones may be performed to assess bones, soft tissues, and joints for damage, lesions, fractures, or other abnormalities, particularly when another type of examination, such as X-rays or physical examination are not conclusive.

Why not C?

• Checking calcium levels will not be useful to confirm the diagnosis of osteoporosis. However, it is more useful in diagnosing osteomalacia and hyperparathyroidism. 

Why not E?

• Bone marrow biopsy is performed to detect haematological malignancies like leukaemia, lymphomas as well as other abnormalities in blood cells and platelets. 

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