Diagnosis dilemma: Is it osteoporosis?

When a younger man presents with symptoms suggestive of osteoporosis, this doctor suspects something else is responsible for the pain
young man back pain

Adam is 38. He has worked in administration but is now receiving a disability pension for depression, for which he is taking sertraline 50mg/day. 

He attends with back pain, which he says is very sharp and started after a minor fall six months ago.