Diagnosis

• Consider assessment of fracture in women aged > 65, men > 75 OR under this age and following risk factors, but not routinely < 50 yrs:
  • Previous fragility fracture
  • Current use or frequent recent use of oral or systemic glucocorticoids or other causes of secondary osteoporosis
  • History of falls
  • Family history of hip fracture
  • Low BMI (less than 18.5 kg/m2)
  • Smoking
  • Alcohol > 14 units per week women, > 21 units per week for men

Investigation

Risk Assessment:

• State absolute risk of fracture over 10 yrs using the following tools, within their age range and no Bone Mineral Density (BMD) available:
  • FRAX
  • QFracture
• Do not routinely measure BMD without prior assessment using FRAX or QFracture
• Measure BMD if assessment predicts at intervention threshold, or < 40 with a major fracture risk
• Recalculate fracture risk if near threshold a minimum 2 yrs elapsed or new risk factor
• Underestimation if: Gluco-cortoicosteroids > 7.5 mg daily, Excessive alcohol, previous vertebral fractures

Management

• n/a

NICE Source: CG146 Osteoporosis: assessing the risk of fragility fracture. Summary compiled by Dr D P Sheppard MBBS.