Question

M.S., a 72-year-old white woman, comes to your clinic for a complete physical examination. She has not been to a provider for 11 years because “I don't like doctors.” Her only complaint today is “pain in my upper back.” She describes the pain as sharp and knifelike. The pain began approximately 3 weeks ago when she was getting out of bed in the morning and hasn't changed at all. M.S. rates her pain as 6 on a 0- to 10-point pain scale and says the pain decreases to 3 or 4 after taking “a couple of ibuprofen.” She denies recent falls or trauma. M.S. admits she needs to quit smoking and start exercising but states, “I don't have the energy to exercise, and besides, I've always been thin.” She has smoked one to two packs of cigarettes per day since she was 17 years old. Her last blood work was 11 years ago, and she can't remember the results.

1.M.S.'s diagnostic test revealed a bone density T-score of –2.7. How will this be interpreted?

Answer 1

M.S bone density of -2.7 shows that her bone density is low .

The normal level of bone density is -1.0 or above. Levels of 0, 0.9 , - 0.9 are considered normal. While that of -1.0 and 2.8 is considered low bone density.  

M.S is 72 years old and has a history of smoking. As the person ages , the osteoblastic activity ( bone forming activity) is reduced when compared with osteoclastic activity . This predisposes risk for osteopenia or low bone density which is again aggrevated by smoking. This is the reason for M.S low bone density causing her severe upper back pain.

Moderate regular exercise, avoiding smoking and alcohol can prevent this condition as the person age.

Thank you.