and Fracture prevention
Osteoporosis (OP) describes the silent thinning of bones that can lead to an increased risk of fracture. Patients may be any age or sex but post menopausal women are particularly susceptible. Patients usually do not experience any symptoms unless a fracture occurs. Fractures are associated with pain with a resultant reduction in quality of life of the patient.
Osteoporosis can be diagnosed in several ways. A special x-ray called a bone mineral density (DEXA) scan is often the starting point. The results of this are combined with a clinical assessment to calculate which patients are at high risk of fracture within the next 10 years, The internationally validated FRAX score is the most commonly used system. There are many treatments for OP including bisphosphonates and denosumab which slow the rate of bone turnover, and strontium which in addition can strengthen the outside of the bone. Other therapies include Teriparatide which is injected daily for a period of time. For some patients no medical treatments may be required if reversible lifestyle factors are identified,
Fracture Liaison Services (FLS)
A FLS service is a state of the art way of identifying patients at high risk of fractures and intervening to reduce this risk. Ideally everyone over 50 years old who has a fracture should have access to a FLS service to be seen within 6 weeks of the fracture. The aim is to assess bone health but also look for other risk factors that may be relevant such as balance or medications, in order to reduce the chances of that person having a further fracture in the future. Evidence shows us that this group of individuals are at a particularly high risk of further fractures and this risk may be improved with prompt recognition and intervention. Talk to your GP about a referral if you feel that such a service may be relevant to you.