Rheumatology - Osteoporosis Flashcards
What is the difference between osteoporosis and osteopenia?
Osteopenia is less severe decrease in bone density
What is the T-score based off of?
T-score of the femoral neck measured on a DEXA scan
T-score is the number of standard deviations away from an average healthy adult
Complete the table
How is bone mineral density measured?
DEXA scan
What is the difference between Z-score and T-score?
Z-score is number of deviations the person is for their age
T-score is healthy adult
T-score used for diagnosis
Who should be assessed for osteoporosis?
Long-term steroid users
50 and over with risk factors
Women over 65
Over 75
What is used to calculate risk of osteoporotic fracture and hip fracture?
QFracture tool
FRAX tool
When are patients considered for DEXA scan after QFracture tool?
If they are above 10% risk of major osteoporotic fracture and hip fracture
When can a DEXA scan be done without investigations?
Over 50 with fragility fracture
Treatment can be started without DEXA in patients with vertebral fracture
How is osteoporosis managed?
Address reversible risk factors
Address insufficient calcium intake
First-Line
Bisphophonates
Second-line
Denosumab
What are some potential side effects of bisphosphonates?
Osteonecrosis of the jaw
Osteonecrosis of the external auditory canal
Atypical fractures
Reflux and oesophageal erosions
How are bisphosphonates taken?
Once weekly
Empty stomach
Sit upright for 30 minutes after to reduce reflux risk
What are two important bisphosphonate examples?
Alendronic acid (oral, once weekly)
Zoledronic acid (IV, once yearly)
How often should patients with osteoporosis be reassessed?
3-5 years
