Abstract
A 64-year-old Vietnamese female presents for initial evaluation of osteoporosis with a chief complaint of new left thigh pain of 1 month's duration. She was diagnosed with osteoporosis at age 54, when she was started on alendronate 70 mg once weekly. She continues on weekly alendronate. There is no fracture history. She reached menopause at age 49. She takes 600 mg of calcium carbonate daily and 1,000 international units of vitamin D daily. No family history of osteoporosis. Available dual-energy X-ray absorptiometry (DXA) scans were reviewed. At age 59, DXA showed the following T-scores: L1 to L4 of -1.9, right femoral of -1.8. At age 62, DXA scan showed a T-score at L1 to L4 of -1.9, right femoral neck T-score -1.8, and total hip T-score -0.5. Bilateral hip X-rays were obtained (Figs. 1 and 2). What is the diagnosis? Fig. 2 View Large Image Figure Viewer
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