A 65-year-old female complains of hip pain that worsens when walking and climbing stairs. She has a history of rheumatoid arthritis and has been on corticosteroids for the past five years. On examination, the hip joint reveals no signs of inflammation. What could be the possible causes and next steps?
Long-term corticosteroid use is a known risk factor for osteoporosis, and this patient's hip pain could be due to osteoporotic fractures. This could be confirmed with imaging of the hip, such as an X-ray. A bone density scan (DEXA) can also help confirm the presence of osteoporosis. If osteoporosis is confirmed, medication to slow the rate of bone loss, such as bisphosphonates, should be considered, and the patient should be advised to maintain a diet rich in calcium and vitamin D.