In patients with spinal cord injury and osteoporosis, which risk is increased?

• A. Increased risk of lower limb osteoporosis
• B. Increased risk of upper limb osteoporosis
• C. Increased risk of brain fracture
• D. Increased risk of osteoporosis in the spine

Answer: (A)

Disuse from spinal cord injury causes bones that aren’t loaded to lose density fast. The major effect is on the weight-bearing long bones of the legs (like the distal femur and proximal tibia), where bone mineral density drops most due to the lack of mechanical strain. That makes lower-limb osteoporosis the most prominent and increased risk in this setting. Upper limbs still receive loading through wheelchair use, so osteoporosis there is less pronounced. Brain fractures are not a typical consequence of osteoporosis, and while spine bone loss can occur, the pattern after SCI is greatest in the lower extremities. So the increased risk is in the lower limbs.