Patient case (clinical description): A 55-year-old white woman comes for a routine checkup.  She has no significant medical history and does not use tobacco, alcohol, or illicit drugs.  The patient's only medication is an over-the-counter multivitamin.  Family history is notable for a hip fracture in her mother.  Blood pressure is 130/80 mm Hg and pulse is 112/min. She has occasional back pain and lives a sedentary lifestyle with the BMI of 24 Kg/m2. Plain X-ray of the spine shows mild compression fracture at the level of T10. X-ray absorptiometry studies demonstrate abnormally low bone density in the lumbar vertebrae and T-score values below -2.5, which confirms the diagnosis of osteoporosis.

Patient's own account: I'm a 55-year-old white woman and I recently visited my family doctor. I don't smoke anything or drink. I don't have any remarkable medical history. I only use over-the-counter multivitamins to keep myself fresh and energized. My mom had a hip fracture. The doctor took my blood pressure and it was 130/80 and my pulse was 112/min. I have annoying back pain from time to time and to be honest I don't exercise much or move much. My BMI is 24. I did a spine X-ray a while ago and my doctor showed me that I have a fracture on one of my vertebrae. I also have a low bone density in my lumbar vertebrae and T-score values below -2.5. The doctor diagnosed me with osteoporosis.

Clinical trial: A Study to Examine the Effects of an Experimental Drug on Postmenopausal Osteoporosis (MK-0822-004)

Eligibility criteria:
Inclusion Criteria:

          -  Postmenopausal for 5 or more years, defined as no menses for at least 5 years OR at
             least 5 years status post bilateral oophorectomy

          -  Bone mineral density T-score at the hip or spine of -2.0 or less

          -  Spinal anatomy suitable for dual-energy x-ray absorptiometry (DXA). At the lumbar
             spine, there is no evidence of vertebral fracture in at least 3 vertebrae in the L1 to
             L4 region on baseline spine films. (Significant scoliosis, bony trauma, degenerative
             joint disease, and sequelae of orthopedic procedures that result in anatomy that is
             unsuitable for accurate bone densitometry must be absent from the lumbar spine.)

          -  At least one hip must be evaluable by DXA (e.g., contain no hardware from orthopedic
             procedures)

          -  In a state of general health allowing for successful completion of the trial

          -  Agreement to not use any medications to treat osteoporosis during the study

        Exclusion Criteria:

          -  History of prior osteoporotic fracture (unless declined treatment with or was
             ineligible for osteoporosis therapy)

          -  Past treatment with osteoporosis medications, steroids, hormone replacement, as well
             as various other medications that affect bone may be exclusionary. (Different
             exclusion criteria apply to each bone active drug. For example, any prior use of
             intravenous (IV) bisphosphonates is not permitted. By contrast, prior use of hormone
             replacement for several years is permitted if it has not occurred within the past 6
             months. Please ask the study doctor for details)

          -  Significant clinical or laboratory abnormalities at the screening visit for the study
             that, in the opinion of the investigator, could complicate interpretation of the study
             results or pose additional risk to the patient (for example, patients who are
             non-ambulatory should be excluded for this reason)
Female
No healthy subjects accepted to join the trial.
Subject must be at least 45 Years old.
Subject must be at most 85 Years

Eligibility (NLI label): Contradiction