I am a 43-year-old male. I had been diagnosed with autoimmune polymyositis four years ago. I was previously a sportsman for most of my life with a reasonably healthy diet. I have been on Prednisolone and Azathioprine for four years, on Methotrexate for four years, and Folic acid. I just had a DXA bone scan with a Z-score of -3.4 in the spine, and -1.7 in the hip. I know corticosteroids can contribute to reducing BMD, but is this extent normal in less than four years? My rheumatologist is away for a few weeks. Please help. What do these results mean? Does it imply osteoporosis? Please advise as to what I can do next. Should we eliminate causes other than corticosteroids?