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A 16-year-old girl presents for evaluation of secondary amenorrhea. Her menarche was at the age of 12 years. Her last menstrual period was 6 months ago. She has lost 2.3 kg (5 lb) over the past 3 months and reports a 2-week history of unilateral foot pain. She typically runs 10 km (6 mi) per day, at least five times per week. Her body-mass index is 19. How should her case be evaluated and managed?
Catherine M. Gordon (Wed,) studied this question.