Some may notice a slight loss of height. Often, a broken or fractured bone is the first sign of a possible problem with your bone mass. This is why bone density scans are recommended for people as they age, the first around age 50 to get a baseline reading and another in 1 to 2 years to assess the rate of loss. bone. Ivy, being a 60-year-old Asian-American woman, has several possible additional risk factors for osteoporosis. Up to 90% of Asians are lactose intolerant (WebMD, n.d.), which could lead to reduced dietary calcium intake, which is necessary for bone development. Many Asians also have a slim figure and therefore have less bone mass to begin with. Ivy was also diagnosed with rheumatoid arthritis several years ago. Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks its own cells, particularly around the joints. It causes pain, inflammation and stiffness in the affected joints, especially those of the hands and feet. Certain medications given for RA, called glucocorticoids, can trigger more bone loss, and this loss is greatest near joints that have RA symptoms. Ivy suffered a broken ankle, where RA tends to be present.