Why differential diagnostic consideration of osteoporosis in old age should not be overlooked

Czech version

Authors: Martina Salátová; Ivana Kecman; Andrea Šofranková; Barbora Kubáčková; Darina Matvějeva; Kateřina Vlachová; Pavlína Piťhová; Milan Kvapil
Authors‘ workplace: Geriatrická interní klinika 2. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Motol a Homolka, Praha, Centrum následné péče Fakultní nemocnice Motol a Homolka, Praha
Published in: Geriatrie a Gerontologie 2026, 15, č. 1: 35-37
doi: https://doi.org/10.61568/geri/50-6703/20260311/143076

Overview

We present a case report of a 74-year-old geriatric patient who was hospitalized at the internal medicine department for back pain without radiation. Magnetic resonance imaging revealed compression fractures of the 12th thoracic and 1st lumbar vertebral bodies. The vertebrogenic findings were consulted with a neurosurgeon, and conservative management was recommended. A preliminary diagnosis of senile osteoporosis complicated by fractures was established, and the patient was transferred to the Geriatric Internal Medicine Clinic of Motol University Hospital.

However, initial laboratory evaluation revealed abnormalities in calcium–phosphate metabolism, which prompted further diagnostic work-up. Surprisingly, the final diagnosis was multiple myeloma (MM). This condition typically presents with osteolytic lesions or osteopenia and is often associated with severe pain, pathological fractures, spinal cord compression, vertebral collapse, and hypercalcemia.

Keywords:

Multiple myeloma – differential diagnosis – osteoporosis – compression fracture

Sources

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