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Not all stoops are due to osteoporosis.

Case report A 75 year old woman presented to her local hospital with diffuse low lumbar spine pain and a mild stoop. There was no radiation of pain to the lower limbs. A diagnosis of osteoporosis was made and the patient started to take etidronate (Didronel PMOT). At that time also, a plain lumbar spine radiograph was performed, but not bone densitometry. Three years later the patient presented to our unit with a six month history of an increasingly severe stoop involving the lumbar and thoracic spine despite continued use of etidronate. At the time of presentation, she was unable to rise from a 90 degree anterior inflexion of the spine and found it difficult to do any housework as her head was below the work surface (fig 1). However, the anterior curvature of the spine disappeared completely in the supine position. There was no relevant past medical or family history. The patient was a non-smoker. Apart from the abnormality of posture described above, the examination was normal-in particular, there was no significant weakness in the upper or lower limbs, and no other