A 58-year-old postmenopausal woman with rheumatoid arthritis comes for follow-up. Her disease is well controlled on methotrexate and prednisone 7.5 mg PO daily, which she has taken for 2 years and which her rheumatologist plans to continue. She has had no fractures, does not smoke, drinks little alcohol, and her mother had osteoporosis. Bone mineral density shows a lumbar spine T-score of -2.2 and a femoral neck T-score of -1.9, and the 10-year major osteoporotic fracture risk is 21% (FRAX adjusted for glucocorticoid dose). Serum calcium is normal, 25-hydroxyvitamin D is 55 nmol/L (75-250), eGFR is 88 mL/min, and she has no esophageal or dental problems.
| Heart rate | 72/min |
| Temperature | 36.8 °C |
| Blood pressure | 128/78 mm Hg |
Question 1 of 44
Which of the following recommendations should be provided at this visit?
Select 3. (0 / 3 selected)
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