Assessing Risk Factors For Fracture And Testing For Bone Loss Are The Keys To Preventing Fractures

Osteoporosis does not develop overnight. Bone mass can be lost steadily for many years without experiencing any symptoms or signs of the disease until a bone fractures. For this reason, osteoporosis is often called “the silent thief” – literally stealing our bone mass without giving us any indication whatsoever. If osteoporosis is first diagnosed at the time a fracture occurs, it is already fairly advanced. A fragility fracture is the most significant clinical consequence of osteoporosis, and therefore preventing a fracture, or the second fracture if one has already occurred, is of paramount importance.

Who should be assessed for risk fracture?

• Women and men over 50 to identify those at high risk
• Anyone over 50 who has experienced a fragility fracture

How is the Assessment Done?

• Detailed history to identify risk factors for low BMD, future fractures and falls:
  • Prior fragility fracture
  • Parental hip fracture
  • Glucocorticoid use
  • Current smoking
  • High alcohol intake (3 or more drinks per day)
  • Rheumatoid arthritis
  • Inquire about falls in past 12 months
  • Inquire about gait and balance

 Physical examination

• Measure weight
• Screening for vertebral fractures:
  • Measure height annually
  • Measure rib to pelvis distance
  • Measure occiput-to-wall distance
  • Spinal x-ray indicated if there is evidence of vertebral fracture
• Assess fall risk by using Get-Up-and-Go-Test