Risk factors for osteoporosis 2000–2012

Excerpt

With the availability of bone mineral density testing by dual energy X-ray absorptiometry (DXA) and since the mid-1990’s generally safe and effective osteoporosis treatment, the evaluation and management of patients at risk for fracture has evolved. DXA and important fracture prediction tools, such as FRAX [1], plus additional therapies have led to fewer hip fractures in some countries, such as Canada [2]. More recently, however, concerns about long term bisphosphonate therapy side effects, such as osteonecrosis of the jaw [3] and atypical femoral fracture [4] have led to decreased bisphosphonate use [5], whereas fracture liaison services [6] have identified very high risk patients, leading to treatment, fewer second fractures, and even lower mortality. How these competing factors have influenced the management of osteoporosis likely varies from country to country. …