OSCE — Osteoporosis · MBBS OSCE

Brief (to candidate)

You will assess a patient with a presentation consistent with Osteoporosis.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Osteoporosis is a progressive systemic skeletal disease of low bone mass and microarchitectural deterioration of bone tissue, leading to increased bone fragility and a consequent increase in fracture risk. Operationally (WHO) it is defined by a DEXA T-score of minus 2.5 or less at the femoral neck, total hip or lumbar spine; a low-trauma (fragility) fracture establishes the diagnosis regardless of the T-score. It is the commonest metabolic bone disease of older adults and the underlying cause of most fragility fractures (low-trauma — fall from standing height or less) of the vertebra, hip, distal forearm (Colles) and proximal humerus. Commonest in postmenopausal women and older adults; secon

Candidate tasks

Clarify onset, severity, associated features, and red-flag symptoms.
State focused examination priorities.
List first-line investigations and any named score/criteria.
Give immediate resuscitation steps.
Outline definitive management with doses/routes where standard.
Name complications and disposition (ward / HDU / theatre / discharge safety-net).
Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

Domain	Pass behaviours
Definition	Correct working diagnosis language
Assessment	Focused, prioritised, red flags sought
Investigations	Appropriate first-line + interpretation
Emergency care	ABC / time-critical actions first
Definitive care	Specific drugs/procedures, not generic phrases
Safety	Fragility fracture (low-trauma, fall from standing height or less) at any age -
Safety	Low-trauma hip fracture in an older adult - orthogeriatric pathway, early surgic
Safety	Height loss over 4 cm, acute thoracic back pain and progressive thoracic kyphosi
Communication	Clear plan and safety-netting

Model outline

Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.