1. The patient did not have "severe osteopenia". She had osteoporosis. Actually, she had just developed severe (or established) osteoporosis.
2. She had a compression fracture at L1. This can be noticed on the image, and inspection of the BMD results shows a 30% increase in bone density of L1. Calculating the results of L2-4, she lost 0.8%. An observant radiologist may have noticed the bone scan showing an increase at L1, the chest xray showing a fracture at L1, and the MRI showing a collapse at L1. Furthermore, the hip showed a decrease in bone density.
Thus, she actually has an increased risk for fractures in the spine.
I should note that DEXA images should not be used to diagnose fractures, and many other compression fractures do not show up on the standard DEXA. The newest machines, however, also can take lateral images that can detect moderate and severe compression fractures.
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