You are a physician seeing a 62-year-old woman with postmenopausal osteoporosis.
Her bone mineral density, as measured by dual-energy x-ray absorptiometry,
is 2.5 SDs below the mean value in premenopausal women. Although she does
not have back pain, a spinal radiograph shows an old vertebral fracture. The
patient has not yet experienced problems as a result of her vertebral fracture,
but she is disturbed by the prospect that she may end up like her mother whose
osteoporotic fractures have resulted in severe, long-term back pain.