History A 75-year-old woman presented to the GP with persistent severe lower back pain that aggravated further after carrying a heavy suitcase at the airport. She reported smoking 30 cigars a day and consuming four bottles of wine a week. Past medical history Increased back pain for the last ten years with a stooped posture. The height decreased by 10 cm during this period. A history of severe chronic asthma. The patient was on oral corticosteroids and steroid inhalers daily.
She reported a Colles fracture in the left wrist two years ago. At the age of 42, the patient had her menopause. Physical examination After a thorough physical examination, the following facts were revealed: The patient had thoracic kyphosis. Tenderness in the L4 vertebra. Moon face, abdominal striae and several bruises on the arms and thighs Laboratory examination Hemoglobin: 11.9 g/dL Mean corpuscular volume:…
