A case study on osteoporosis in a male athlete: looking beyond the usual suspects.

After presenting with chronic low back pain, a male track athlete was diagnosed with bilateral lysis at L5, slight listhesis at L5 on S1; asymmetrical lysis at L4; and right L5/S1 disc bulge with minimal S1 nerve root contact. Conservative treatment was chosen. After participating in a bone density pilot study using dual-energy X-ray absorptiometry (DEXA) investigating alcohol consumption patterns in intercollegiate athletes, he was diagnosed with osteopenia and osteoporosis in his lumbar spine. Therapeutic drug intervention and rehabilitation were initiated.Athletes with normal physiologic functions can have idiopathic osteoporosis, which may or may not be related to alcohol consumption. Although the relationship among chronic alcoholism (South-Paul, 2001), weight-bearing exercise (Kalsson, 2001), and bone density have been established, the relationship among binge drinking, intercollegiate athletic participation, and bone density has not. Despite suspected normal presentation, nonresponsive low back pain should be investigated thoroughly for advanced bone conditions.