BMD suggesting osteopenia in a post-menopausal woman

Patient

Q: I am a 65 year old lady. I have 3 thoracic vertebrae in my upper back that are misaligned. I have had this condition for many decades. I donot know if this was congenital or caused by a fall. However, the vertebrae are stable and donot cause me pain. I sometimes get muscle spasm adjacent to the area affected. At the suggestion of my GP, I recently had my bone density (Bone Mineral Densitometry)tested. These were the lab results: Fragility fractures after age 40:negative. Sytemic glucocorticoid use of greater than 3 months:negative. BMD measuremnet of lumber spine from L1 to L4 corresponds to WHO classification of Ostopenia. BMD measuurement of left hip WHO Classification: normal. As compared with the previous study of November 5, 2004 in the L-spine: there is no statistcally significant change. In left hip no statistically significant change. As compared with the baseline study of July 28, 2000 in the L-spine: there is statistically significant decrease. Ten year absolute fracture risk: Moderate (10-20%) Recommmendations: Lifestyle modification and nutritional supplements would be helpful. Follow up BMD recommended. After looking at the results, he put me on CO ETIDROCAL bone metabolism regulator DIN 02263866. As I understand it from the lab results I donot have Osteoporosis but Ostopenia which is not even considered a diagnosis. Why am I on this medication? Is this prescription necessary for me? On the bottom of the lab sheet the recommendations only included lifestyle modification and nutritional supplements. I understand this to be weight bearing exercise like walking and consuming more food containing calcium or taking calcium supplements. Is that not adequate for my situation based on the lab results?

Doctor

A:    Possibly your GP doctor prescribed “Co Etidrocal” considering your age, post-menopausal status, no replacement hormone therapy, the compared changes between BMD in 2000 and the most recent one showing significant BMD decrease and  the moderate risk of fractures  (10-20%). The “Co Etidrocal” contains two different components: etidronate and calcium carbonate, is used to prevent and treat osteoporosis in post-menopausal women, increasing the density of the bones and making them less prone to break. However, you always have the right to get a second opinion from a specialist in gynecology.

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