A 70 years old female is on treatment with Alendronate for 7 years for osteoporosis. Now she complains of pain in right thigh. What is the next investigation to be performed?
Long term use of Alendronate (Bisphosphonates) results in following radiological changes in patients presenting with tigh pain: Earliest change would be thickening coex femur (predominantly the lateral coex) Later it results in subtrochanteric fracture through the thickened coex with medial spike. Hence in this scenario the next investigation would be X ray to see for coical thickening and atypical subtrochanteric fractures.
DEXA scan
X-ray
Serum vitamin D levels
Serum alkaline phosphate levels
Skeletal system