{"ops":[{"insert":"A 65 year old woman presents with persistent pain in her middle and lower back, which started around a month ago, after she attempted to pick up a potted plant.\n\nThe pain is worsened by exertion, and relieved by lying down; it has progressively increased over time. There was no associated tingling, numbness or weakness.\n\nHer menopause was at 48 years of age. She has never been on hormone replacement therapy.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-046_en.png"}},{"insert":"\n"}]}
2
Investigate
X-Ray Lumbar Spine
{"ops":[{"insert":"There is a compression wedge fracture of the L1 vertebral body. The L4\/L5 and L5\/S1 disk spaces are narrowed.\n"}]}
DXA scan and VFA
{"ops":[{"insert":"The DXA scan of the spine gives a T-Score of -2.7\nVFA: Grade 1 stable vertebral wedge fracture deformity of the L1 vertebral body.\n"}]}
