A 46-year-old woman, Mrs. S was referred by her primary care physician ( PCP ) to Dr. A , an orthopedic surgeon due to complaints of groin and back pain . Mrs. S had a history of hypertension and anorexia nervosa and was currently on anti-depressant medication. Previous pelvic examination of the patient revealed non-specific osteopenia and a radiolucency in the pubic ramus. After consideration of the case, Dr. A ordered a bone scan to Mrs.
S to confirm the preliminary diagnosis of stress fractures. Furthermore, Dr. A made a note on the abnormally low bone density of Mrs. S and hinted that this might be due to some systemic condition. After 2 weeks of follow-up , a diagnosis of pubic and sacral stress fractures was made by Dr. A based on the bone scan reports. During this visit, Mrs. S complained of generalized, progressive weakness, and admitted that her pain did not decrease since the…
