Clinical Features of Osteoporosis The clinical features of osteoporosis include pain, which occurs most frequently with crush or compression fractures of the lower thoracis, midthoracic or lumbar spine. Fractures frequently occur spontaneously or with minimal trauma. The most common fractures are those of the vertebral bodies, followed by fractures of the neck of the femur. Femoral neck fractures are the most serious because they lead to considerable morbidity and mortality in the elderly population. Other fractures, such as those of the distal forearm following a fall on the outstretched hand, are less common.