A postmenopausal patient (white race; aged 69 years) was referred to the osteoporosis clinic after a screening dual-energy x-ray absorptiometry (DXA) scan showed low bone mineral density (BMD) of the spine (Table). She had no history of fractures or falls. Menopause began at age 39 years. She never smoked. Her medications included only calcium, 600 mg, and vitamin D, 500 IU twice daily. She was 150 cm tall and weighed 55 kg (body mass index, 24.4). She had normal thyroid, parathyroid hormone, vitamin D, calcium, serum and urine protein electrophoresis, and urinary N-telopeptide levels. She preferred not to take a prescription osteoporosis medication.
Neuner J, Carnahan J. Dual X-ray Absorptiometry for Diagnosis of Osteoporosis. JAMA. 2014;312(11):1147–1148. doi:10.1001/jama.2014.1402