Title: December 2013 – DXA reports loss of bone on bisphosphonate therapy

59 year old postmenopausal Caucasian female on bisphosphonates since age 54 referred because of bone loss.  Weight 183 #, Height 65 inches, unchanged.  Initial repeat DXA at age 55 reported an 8% increase in BMD of the spine.  At age 57, BMD was stable but DXA at age 59 reported a 7.5% loss of bone density in the spine, no change in the total hip or femoral neck.  Recent scans shown below:

december-one

QUESTIONS:

  • What could explain bone loss in a patient who previously responded to medical therapy?
  • Are there any technical problems with this scan?

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