Management and treatment of osteoporosis and fracture prevention in primary care

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Management and treatment of osteoporosis and fracture prevention in primary care

Osteoporosis can be defined as the condition which involves decreased bone strength, hence increased susceptibility to fractures. It is characterized by the low bone mineral density (BMD) and the majority of the fractures occur in hip, spine and wrist.

Osteoporosis Risk Assessment
While assessing risk of fragility fracture, it is important to consider the following patient groups:
a) Women ≥ 65 years and men ≥ 75 years
b) Women/Men of above age with an earlier fragility fracture known as ‘following trauma equal to or less than falling from a standing height’ or any of the following risk factors:

  • Regular use of oral/systemic glucocorticoids
  • Heavy smoking (>10 cigarettes per day)
  • History of falls
  • Alcohol intake > 4 units per day
  • Past history of hip fracture
  • Low BMI ≤ 18.5 kg/m2
  • Other causes of secondary osteoporosis: rheumatoid arthritis, and other inflammatory arthropathies, celiac disease, inflammatory bowel disease, chronic liver disease, chronic pancreatitis, other causes of malabsorption, untreated premature menopause, hyperthyroidism, primary hyperparathyroidism, Cushing’s disease, type 1 diabetes, hypogonadism, hyperprolactinaemia, treatment with aromatase inhibitors or androgen deprivation therapy (GNRH analogues) or homocystinuria, multiple myeloma, haemoglobinopathies, systemic mastocytosis, HIV positive, chronic renal disease, COPD on long-term glucocorticoids, cystic fibrosis.
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The National Institute for Health and Care Excellence
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