Primary osteopenia in a female military flight crewmember

This report describes a case of primary severe osteopenia in a 35-yr-old female crewmember of a USAF transport aircraft. This previously healthy individual presented with musculoskeletal symptoms that led to the incidental finding of severe osteopenia on plain films of the pelvis. The subsequent evaluation, including dual energy X-ray absorptiometry (DEXA) showed a T-score of 1-2 SD below sex-adjusted expected levels for age. Work-up revealed no secondary causes and the patient was placed on alendronate sodium, vitamin D, and calcium supplementation. Within 2 yr, her bone studies were normal. The crewmember was returned to normal flight status and has had no aeromedical problems. Osteopenia and osteoporosis represent points on a continuum of bone disease. Recognizing and addressing risk factors for osteoporosis earlier may reduce the chances for fractures later in life. Aeromedical specialists must be cognizant of the increased risk for bone disease in female crewmembers.