A 78-year-old man on long-term Prednisolone 10 mg daily for polymyalgia rheumatica presents with new-onset back pain and loss of 3 cm in height. X-ray...

Question

A 78-year-old man on long-term Prednisolone 10 mg daily for polymyalgia rheumatica presents with new-onset back pain and loss of 3 cm in height. X-ray of the thoracic spine shows two vertebral compression fractures. He is not on bone protection therapy. What is the MOST important immediate management?

Accepted Answer

Start Alendronic acid 70 mg weekly with calcium and vitamin D supplementation

Answer

Increase Prednisolone to manage his pain

Answer

Request a DXA scan before starting treatment

Answer

Start Denosumab as first-line

Answer

Refer for vertebroplasty

uk-dgm MCQ (SBA): Glucocorticoid-Induced Osteoporosis - Treatment