Muscle strength and sensation are intact in the lower extrem

A 57-year-old woman is brought to the physician 2 days after the sudden onset of severe low back pain; the pain does not radiate to the lower extremities. The pain began when she was lifting her grandson. She does not have weakness or sensory loss in the legs and has had no urinary incontinence. She has a 10-year history of rheumatoid arthritis treated with prednisone. Her temperature is 37 C (98.6 F), blood pressure is 130/60 mm Hg, and pulse is 64/min. Examination shows deformities of the interphalangeal joints of the hands and exquisite tenderness to percussion over the lumbar spine. Bilateral straight-leg raising to 80 degrees does not increase the pain. Muscle strength and sensation are intact in the lower extremities. Deep tendon reflexes are 2+ bilaterally. Babinski's sign is absent bilaterally.

For each patient with back pain, select the most likely diagnosis.


A ) Herniated disc
B ) Lumbar spinal stenosis
C ) Metastatic cancer
D ) Muscle strain
E ) Osteoporotic compression fracture
F ) Sacroiliitis
G ) Spinal epidural abscess
H ) Spondylolisthesis

She has a 10-year history of rheumatoid arthritis treated with prednisone. ---osteoporosis

E) Osteoporotic compression fracture