10-16-2007, 04:01 PM
A 51-year old woman with systemic lupus erythematosus comes to the clinic with right hip pain for the past 3 days. She has no history of trauma. The patient has been postmenopausal for the past 3 years. She takes naproxen, ibuprofen, and prednisone 100 mg a day. She has been taking these medications for the past 10 years. She tells you that she stopped taking estrogen secondary to occasional nausea. Her temperature is 37.4 C (99.4 F). Physical examination reveals a butterfly facial rash, multiple swollen joints of the hands and feet, and a systolic flow murmur. A plain radiograph of the hip is normal. A bone scan reveals decreased 99Tc MDP tracer uptake in the right femoral head. The patient should be advised to
A. avoid weightbearing and immediately stop prednisone
B. avoid weightbearing and taper off prednisone
C. begin an exercise program and calcium supplementation
D. begin an exercise program and taper off prednisone
E. begin an exercise program, calcium supplementation, and estrogen replacement therapy
A. avoid weightbearing and immediately stop prednisone
B. avoid weightbearing and taper off prednisone
C. begin an exercise program and calcium supplementation
D. begin an exercise program and taper off prednisone
E. begin an exercise program, calcium supplementation, and estrogen replacement therapy