Diagnosis dilemma: Is it osteoporosis?
Adam is 38. He has worked in administration but is now receiving a disability pension for depression, for which he is taking sertraline 50mg/day.
He attends with back pain, which he says is very sharp and started after a minor fall six months ago.
He localises the pain to the thoracolumbar region. The pain does not radiate but it is aggravated by coughing.
All back movements are painful. There is no suggestion of bowel or bladder disturbance.
Apart from depression, he has no