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A 56-year-old Caucasian woman is seeing an orthopedist for the first time. She reports a history of several fractures. Six months ago, she sustained a right wrist fracture after falling over a lamp cord in her single-level, carpeted home; 2 months later she fractured her left wrist after tripping and falling. Five years ago she fractured an ankle while making a (bad) landing while sky-diving for the first-and last-time. She had a hysterectomy at age 45 for fibroids; the ovaries were not removed. She experienced menopause at age 51 and has not taken hormone therapy. She is healthy and has not been on chronic medications. Her dietary calcium intake is consistent at about 950 mg daily. She does not use any over-the-counter medications or supplements and does not smoke. She uses sunscreens to protect against skin cancer. She does not engage in regular weight-bearing exercise. Her paternal aunt was diagnosed with osteoporosis after a hip fracture. The patient is 5' 1" and she weighs 105 lbs. Her height has been stable over the past 3 years. A general health assessment in the prior year included a chemistry profile, thyroid studies, urinalysis, and CBC, all of which were normal.
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