Low Energy/No Exercise/Repeated Use Always Check neurological and vascular status one joint below the injury Pathologic/Fragility Fractures PATHOLOGIC FRACTURES Metabolic Bone Disease Tumours See Bone Lesions Scheme Osteoporosis Vertebrae/Hip/Distal Radius Paget's Disease Skull/Spine/Pelvis Positive Alkaline Phosphatase Renal Osteodystrophy Secondary to Chronic Renal Failure Osteomalacia/Ricketts Diffuse Pain/Proximal Muscle Weakness Primary Secondary Vitamin D Deficiency Mineralization Defect Phosphate Deficiency Post-Menopausal Elderly Gastrointestinal Disease Bone Marrow Disorder Endocrinopathy Malignancy Drugs (e.g. corticosteroids) Rheumatoid Disease Renal Disease Poor Nutrition Immobilization Toronto Notes for Medical Students, Inc. (2009). Toronto Notes 209: Comprehensive Medical Reference and Review for MCCQE I & USMLE II. McGraw-Hill: Toronto, Ontario.

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