Metabolic bone disease: DXA site in the elderly: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Orthopaedics · Metabolic bone disease: DXA site in the elderly

Sample item

A 78-year-old woman with severe kyphosis and extensive aortic calcification has a lumbar spine T-score of -0.5 on DXA, yet she has had a hip fracture. Which site should be used for diagnosing osteoporosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Total hip or femoral neck

In older people, osteophytes, vertebral compression, facet sclerosis and aortic calcification add to the signal over the lumbar spine and falsely raise bone density. The hip is less affected and is the preferred site, and a fragility hip fracture alone also establishes osteoporosis clinically.

Option by option

  • A. Lumbar spine at L1 to L4

    The lumbar spine here is falsely raised by degenerative change and calcification.

  • B. Total hip or femoral neck (correct)

    Correct. The hip is the preferred site when spinal artefacts overestimate bone density.

  • C. Calcaneus ultrasound

    Calcaneal ultrasound is a screening tool and does not give a diagnostic T-score in the WHO sense.

  • D. Distal one-third of the radius only

    The radius is reserved for hyperparathyroidism or when the hip and spine cannot be measured.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Orthopaedics questions

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Total hip or femoral neck. In older people, osteophytes, vertebral compression, facet sclerosis and aortic calcification add to the signal over the lumbar spine and falsely raise bone density.

Why is "Lumbar spine at L1 to L4" not the answer?

The lumbar spine here is falsely raised by degenerative change and calcification.

Why is "Calcaneus ultrasound" not the answer?

Calcaneal ultrasound is a screening tool and does not give a diagnostic T-score in the WHO sense.

Why is "Distal one-third of the radius only" not the answer?

The radius is reserved for hyperparathyroidism or when the hip and spine cannot be measured.

What concept does this question test?

It tests Metabolic bone disease: DXA site in the elderly in Orthopaedics. The hip is less affected and is the preferred site, and a fragility hip fracture alone also establishes osteoporosis clinically.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Metabolic bone disease: DXA site in the elderly?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.