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An 89-year-old woman was admitted to the hospital with hypercapnic respiratory failure. She had a long history of osteoporosis. Bone densitometry revealed a T score for the lumbar spine of –4.8. She was taking subtherapeutic vitamin D and calcium supplements and had declined treatment with bisphosphonates. Over a period of 4 years, her T score declined further, to –5.0. A radiographic study showed multiple vertebral compression fractures that resulted in serious kyphosis. Progressive dysphagia secondary to thoracic deformity developed, resulting in a 26% weight loss over a period of 4 years. When she was admitted to the hospital, she reported . . . [Full Text of this Article] |