A 67-year-old woman has a fragility distal radius fracture. DXA shows femoral neck T-score minus 2.6. Calcium intake is low, 25-hydroxyvitamin D is

Question

A 67-year-old woman has a fragility distal radius fracture. DXA shows femoral neck T-score minus 2.6. Calcium intake is low, 25-hydroxyvitamin D is 18 ng/mL, creatinine clearance is 74 mL/min, and dental health is stable. Which of the following is the most appropriate management?

Accepted Answer

Vitamin D repletion, calcium optimization, weight-bearing exercise, and bisphosphonate therapy

Answer

Estrogen therapy as first-line fracture prevention at age 67

Answer

Chronic high-dose glucocorticoids

Answer

Calcitonin nasal spray as preferred long-term therapy

Answer

Observe until hip fracture occurs

Postmenopausal osteoporosis — ABIM Board MCQ

A 67-year-old woman has a fragility distal radius fracture. DXA shows femoral neck T-score minus 2.6. Calcium intake is low, 25-hydroxyvitamin D is 18 ng/mL, creatinine clearance is 74 mL/min, and dental health is stable. Which of the following is the most appropriate management?