28th May 2025

A 68-year-old man has been experiencing severe bone pain for the past 12 months, achieving minimal relief with analgesia and occasionally waking the patient up at night.

A 68-year-old man has been experiencing severe bone pain for the past 12 months, achieving minimal relief with analgesia and occasionally waking the patient up at night. He presents with acute bone pain in his left femur following a low impact fall from a standing height pain. X-ray of his left femur shows a complete transverse fracture of the left femur. You also note osteolytic lesions along the length of the femur. On review of his pelvic X-ray, you see cortical thickening and sclerosis of the pelvis in an asymmetrical pattern, with similar patterns seen in the left femur.

What is the most likely cause of his fracture?

Select the SINGLE most appropriate option from the list below. Select ONE option only.