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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.
A 55-year-old asymptomatic woman, who is 5 years postmenopausal, is concerned about osteoporosis, since her mother had a hip fracture at the age of 70 years. The patient has no personal history of fractures and has never taken corticosteroids. She does not smoke but does drink one to two glasses of wine a day. Her weight is 105 lb (48 kg), and
The Clinical Problem
Strategies and Evidence
Additional Testing
Assessment for Vertebral Fractures
Markers of Bone Turnover
Watchful Waiting versus Pharmacologic Intervention
Lifestyle Modifications
Pharmacologic Therapy
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Endocrine Research Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine, and the Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN.
Address reprint requests to Dr. Khosla at the Endocrine Research Unit, Mayo Clinic College of Medicine, 200 First St., SW, 5-194 Joseph, Rochester, MN 55905, or to khosla.sundeep@mayo.edu.
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