Perspectives

What’s new in assessing fracture risk?

Perspectives

What’s new in assessing fracture risk?

Nicholas A. Pocock

Figures

© reineg/stock.adobe.com
© reineg/stock.adobe.com

Abstract

Opportunities for primary and secondary minimal trauma fracture prevention are often missed. Effective secondary prevention programs in hospitals and improved imaging technology can help, but awareness of the need to prioritise preventing, investigating and treating osteoporosis is key to reducing the serious impact of osteoporotic fractures on the health of patients.

Key Points

  • Currently in Australia, the number of patients who have sustained a minimal trauma fracture who subsequently receive treatment is low.
  • Identification of patients who have sustained a minimal trauma fracture is crucial.
  • Fracture liaison services have been shown to improve the number of patients receiving treatment after fracture and to reduce the likelihood of subsequent fracture.
  • Trabecular bone score is useful in refining the assessment of absolute fracture risk in patients undergoing dual energy x-ray absorptiometry (DXA) scans and has been incorporated into the FRAX absolute fracture risk calculator.
  • Improved scanning technology and imaging analytics can aid in detection of prevalent vertebral fractures.
  • Bilateral hip DXA scanning increases identification of osteoporosis with negligible additional scanning time or radiation exposure.
  • Quantitative methodologies in ultrasound and high-resolution peripheral quantitative CT, as well as three-dimensional DXA, hold future promise for assessing osteoporosis and fracture risk.