Case Submitted by: Angela M. Cheung, MD, PhD, CCD, Queenie Wong, MRT(N), CBDT, Heather McDonald-Blumer MD, MSc, CCD
A 63 year old, healthy, Caucasian postmenopausal woman was seen for routine follow-up. She was diagnosed with osteoporosis 10 years ago and had been on alendronate since her diagnosis. (Her mother had a hip fracture.) She reported leading an active lifestyle, took calcium and vitamin D, had never had a fracture and had no history of falls in the past year. Ca / ALP / PTH/ TSH were normal and 25-OH vitamin D was 104nmol/L (41.6ng/ml). Weight 57.5kg, height 152.4cm, BMI 24.8. Her BMD was:
QUESTION: What would you do?
- a) Continue alendronate
- b) Switch to another antiresorptive agent
- c) Discontinue alendronate
- d) Ask if she has any leg symptoms (pain, ache, discomfort). If so, do further imaging.