A 37-year-old man was presented to the clinic with a 4-month history of worsening lower back pain. He had no history of trauma, fracture, smoking, alcohol or drug consumption. Family history was adverse for gonadal, endocrine, or bone diseases.
He had H/o testosterone injections for three years due to delayed puberty. As a result, he observed decreased libido for several years and an absence of morning erections. Examination of the integument was remarkable for the sparsity of pubic hair. The penile length was average, but testicular volume was decreased.
Complete blood count showed normochromic normocytic anaemia with extreme low serum levels for LH, FSH, testosterone, oestradiol and 25(OH) vitamin D levels. Radiographic investigation of the spine revealed diffuse osteopenia with moderate wedging of several mid-thoracic vertebrae along with severe compression fractures of T11, T12, and L1 (80%–90% vertebral height loss) as shown in the image
Based on these reports, the patient was diagnosed, and therapy was started, including analgesics, calcium, teriparatide and testosterone replacement therapy
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