How do you determine osteoporosis treatment response when patients have discrepant DEXA scan results during monitoring (eg improved BMD of the hip and spine but worsening BMD of the femoral neck)?

How do you determine osteoporosis treatment response when patients have discrepant DEXA scan results during monitoring (eg improved BMD of the hip and spine but worsening BMD of the femoral neck)?

• I monitor bone turnover markers
• I ask the patient if they have sustained any fractures while on treatment
• I tell my patients that BMD scores are helpful predictors of fractures before starting osteoporosis therapy but not a good indication of treatment response
• Other