Reference no: EM133830080

Question

A 76-year-old woman is brought to the emergency department (ED) by ambulance with an externally rotated, abducted, and shortened left lower extremity. The patient says she fell out of bed and could not get up. Prior to the fall, she states she did not have any head trauma, preceding syncopal events, or a history of falls. Her past medical history includes restrictive lung disease for several years but no recent hospitalizations. She has no allergies to medications and has never had an adverse drug reaction. Her only recent medication is bisphosphonate anti-resorptive therapy for a previous vertebral fracture (eight years ago), and she has been on a drug holiday for three years after five years of treatment. Her age of last menstruation was 51 years. Her family history includes lung cancer in her father. There is no family history of hip fracture. She does not smoke, use alcohol, or have a hazardous occupational exposure. Her diet has not recently changed, and there is no recent weight loss. She lives with her daughter and son-in-law and is minimally active, rarely getting sunlight. The review of systems is negative for recent headache, migraine, fevers, cough, urinary changes, hematochezia, melena, or abdominal.