8th September 2020

76-year-old Scott presents to A&E following a fracture to his hip

76-year-old Scott presents to A&E following a fracture to his hip, which he sustained after a fall from standing height. For the last few months before his fracture, Scott has been experiencing some aches and pains in his leg bones and in his hips. Aside from these aches and pains, he has also found it increasingly difficult to stand when getting out of chairs, or out of bed. He feels his legs aren’t as strong as they usually are. 

Scott has coeliac disease but no other ongoing medical conditions. He has no family history of note.

Scott mobilises independently and is independent in his activities of daily living. 

He is afebrile today, oriented to time, place and person, and his daughter, who came to A&E with him, tells you that aside from being in pain, he seems himself today. There are no areas of erythema or swelling in his legs today and initial investigations have shown a normal CRP and WCC. 

Which of the following diagnoses is the most likely explanation for Scott’s fracture?  Select the SINGLE most appropriate option from the list below. Select ONE option only.