58 year old postmenopausal female presents for a DXA scan prior to beginning an aromatase inhibitor for breast cancer. Height 61.6 inches, weight 165 pounds. Patient reports a 2 inch loss of height, lateral spine x-ray performed to evaluate for unrecognized vertebral fractures.
1. What is the diagnosis?
2. Does the lateral spine x-ray suggest a different diagnosis?
3. What is this patient’s risk for fracture?
4. Would you recommend pharmacologic treatment for this patient?
Case submitted by William Leslie MD CCD and Susan Broy MD CCD