30th April 2024

A 70-year-old woman presents with a history of two wrist fractures within the past year, both resulting from minor falls.

A 70-year-old woman presents with a history of two wrist fractures within the past year, both resulting from minor falls. She mentions experiencing height loss and back pain. She has a history of early menopause and has been on long-term prednisolone therapy for rheumatoid arthritis. She has no known family history of osteoporosis.

Investigations:

Haemoglobin: 132 g/L (120–160)

Calcium: 2.32 mmol/L (2.2–2.6)

Serum alkaline phosphatase: 85 U/L (30–130)

Serum creatinine: 88 μmol/L (45–84)

TSH: Normal

Which investigation will most effectively evaluate her bone density and future fracture risk?