Question

Helen, age 74, presents with a complaint of low back pain. Red flags in her history of a minor fall, having osteopenia, and prolonged steroid use for systemic lupus erythematosus suggest the possibility of which of the following serious underlying conditions as the cause of her low back pain?

1) Osteoarthritis
2) Spinal stenosis
3) Compression fracture
4) Metastatic cancer

Answer 1

Helen's history of a minor fall, osteopenia, and prolonged steroid use for SLE suggests that a compression fracture is the likely serious underlying condition causing her low back pain.

Step-by-step explanation:

Helen, age 74, with a history of a minor fall, osteopenia, and long-term steroid use for systemic lupus erythematosus (SLE), presents with low back pain. These factors suggest a high possibility for a compression fracture as the serious underlying condition causing her pain. Steroid use and osteopenia contribute to decreased bone density and strength, which along with a history of a fall, significantly increases the risk of fractures, especially in the elderly.

Osteoporosis is a condition characterized by a reduction in bone mass and density, leading to an increased risk of fracture. In Helen's case, her lower bone density (osteopenia) could be a precursor to osteoporosis. Osteoporosis most often affects the vertebrae, wrists, and femur. Coupled with the long-term steroid use for her lupus, Helen's bones are likelier to be more fragile, making a compression fracture a probable diagnosis following a fall.