Pre-Consult Patient Intake

Basic Information:  
- Name: Not provided.  
- Date of Birth: Not provided.  
- Gender: Female  
  
Chief Complaint:  
- Postmenopausal osteoporosis management  
  
Subjective:  
- History of present illness: The patient was previously seen for postmenopausal osteoporosis. She has various somatic complaints including right hip and spine arthralgias. No previous fracture history reported.  
- Past medical history: Postmenopausal osteoporosis.  
- Medications: Residronate (taken for approximately 10 years, starting at age 52), vitamin D 800 units daily.  
  
Objective:  
- Bone density (October 2022): L1-4 T-score -2.6, total hip T-score -2.0, femoral neck T-score -2.4. Deemed low risk for osteoporosis at that time. Drug holiday from bisphosphonates recommended to reduce risk of ONJ and atypical femoral fractures.  
- Bone density (November 2025): L1-4 T-score -2.4, left total femur T-score -2.1, left femoral neck T-score -2.6. Compared to October 2022, L1-4 increased by 3% (borderline significant), left total femur stable.  
  
Assessment:  
- Postmenopausal osteoporosis, currently low risk. No history of fragility fractures. On drug holiday from bisphosphonates.  
  
Plan:  
- Continue drug holiday. Monitor bone density and clinical status.  
  
Tests:  
Imaging Tests:  
- Date: October 2022  
  Test Type: Bone Density (DXA)  
  Description: L1-4 T-score -2.6, total hip T-score -2.0, femoral neck T-score -2.4.  
- Date: November 2025  
  Test Type: Bone Density (DXA)  
  Description: L1-4 T-score -2.4 (3% increase from prior), left total femur T-score -2.1 (stable), left femoral neck T-score -2.6.