OsteoEd

Treatment Basics

Matthew Hollon, MD, MPH

A 67-year-old woman presents to you with a DXA scan obtained from a mobile bone density testing unit at a local mall. The readout lists a T-score of -1.8 at the femoral neck. She has been healthy most of her life and relates no medical problems or active complaints. She takes vitamins but no other medications.

Click an answer under each question.

1. How would you categorize your patient's bone density using World Health Organization criteria?

   • Option A Normal
   • Option B Osteopenia
   • Option C Osteoporosis

2. Aside from advising adequate calcium and vitamin D intake, should your patient be offered drug treatment at this time?

   • Option A Yes
   • Option B No
   • Option C Need more risk factor information

3. She has no history of fracture, negative family history of osteoporosis. She is a non-smoker and non-drinker. Her exam is normal and her weight is 153 lbs. Given the lack of osteoporosis risk factors, do you recommend treatment at this time?

   • Option A Yes
   • Option B No

4. Because of her lack of risk factors and her general inclination to avoid taking medicines, you mutually decide to avoid drug treatment at this time. Six months later she slips on a rug in her home, falls, and suffers a compression fracture.

   

   Which of the following should you do next?

   • Option A Recheck her hip and spine bone density and treat if her T-score is -2.5 or less
   • Option B Recommend treatment for osteoporosis

5. Are there non-hormonal options for treatment?

   • Option A Yes
   • Option B No

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