Review Question - QID 216381

A 40-year-old woman from rural Maine presents to her primary care physician with a complaint of progressively worsening left groin pain over the last month and a half. The pain is present at rest and worsens with weight bearing. The patient stays active by running, but she has stopped running due to the pain. She does not recall any specific trauma. Past medical history is significant for systemic lupus erythematosus requiring multiple courses of prednisone. The patient's temperature is 98.9°F (37.2°C), blood pressure is 145/82 mmHg, pulse is 90/min, and respirations are 14/min. Physical exam is significant for central obesity with thin extremities and a round face. A normal S1 and S2 heart sound are heard on cardiac auscultation with no murmurs. Forced abduction and internal rotation of the left femur elicits pain, and range of motion is reduced. Patellar and ankle reflexes are 2+, and there are no sensory deficits. A radiograph of the left hip shows no significant abnormalities. Her body mass index is 24 kg/m^2. Which of the following aspects of this patient's history places her at greatest risk for her current condition?