The X-rays shown here are from an elderly woman who presented with mechanical low back pain. She had a prior operation for an osteoporotic fracture of the right hip joint. X-ray of the lumbar spine (AP and lateral) showed osteoporotic collapse of L1. Her pain was managed with panadol, tramadol and a 2-week course of intranasal calcitonin. She was prescribed with oral calcium and vitamin D supplements as well as weekly oral alendronate for her osteoporosis. A soft corset was prescribed and she received physiotherapy for pain control and strengthening of the back muscles.