14th September 2020

Mrs Cope, a 63-year-old lady, is admitted to the orthopaedic ward after fracturing her hip

Mrs Cope, a 63-year-old lady, is admitted to the orthopaedic ward after fracturing her hip after a fall from standing height. Her test results are below:

• Hb: 120 (115-165g/L)
• WCC: 5.2×10⁹ (3.6-11.0×10⁹/L)
• Platelets: 144×10⁹ (140-400×10⁹/L)
• Na: 135 (133-146mmol/L)
• K: 4.2 (3.5-5.3mmol/L)
• Ca (adjusted): 2.4 (2.2-2.6mmol/L)
• Urea: 7.2 (2.5-7.8mmol/L)
• Creatinine: 48 (45-84μmol/L)
• ALP: 72 (30-130U/L)
• ALT: 28 (<33U/L)
• CRP: 56 (<5mg/L)
• PTH: 3.5 (1.6-6.9pmol/L)
• DEXA scan: T-score = -3

What is the reason for her fragility fracture?

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