Fracture Type Flashcards
Does FRAX over-estimate or under-estimate fracture probability in individuals with a parental history of non-hip fragility fracture?
Underestimates fracture probability
Is a fragility fracture an indication for bone density testing?
Yes
What is the definition of severe or established osteoporosis?
Bone density that is 2.5 standard deviations or more below the young-adult normal mean (T-score at or below -2.5) with at least one fragility fracture.
Name a cause of primary osteoporosis in children that is a result of a genetic defect in collagen synthesis.
Osteogenesis imperfecta
Which site in post-menopausal women does pQCT of the forearm predict fragility fracture at?
Hip
Not spine
Which site in men does pQCT of the forearm predict fragility fracture at?
There is lack sufficient evidence to answer this question
Which device predicts fragility fracture in post-menopausal women (hip, vertebral, and global fracture risk) and men over the age of 65 (hip and all non-vertebral fractures), independently of central DXA BMD?
Clue: validated skeletal site is the heel
QUS device
Do validated pDXA devices have stronger or weaker vertebral fracture predictive ability in post-menopausal women than central DXA and heel QUS?
Weaker
Can measurement by validated pDXA devices be used to assess vertebral and global fracture risk in post-menopausal women?
Yes
Can measurement by validated pDXA devices be used to assess vertebral and global fracture risk in men?
There is lack of sufficient evidence to support this position in men.
Have FDA-approved osteoporosis treatments been shown to decrease fracture risk in patients who have had fragility fractures?
Yes
Teriparatide reduces the risk of non-vertebral fragility fractures by about ____ % in patients with osteoporosis, after an average of ____ months of therapy.
53%
18 months
What is the advantage of bone density measurement compared to standard x-ray radiographs?
Patients at high risk of fragility fractures are frequently identified earlier in the disease, before changes appear on standard x-rays.
The lower a patient’s T-score, the more likely that a fragility fracture will occur.
True or false?
True
What does osteoporosis do via micro-architectural changes in bone?
Increases the risk of fragility fractures
Do patients with bone density T-scores better than -2.5 have a lower risk of fragility fractures?
Yes
What is a fragility fracture?
An osteoporotic fracture or low-trauma fracture that occurs with a force less than or equal to falling from a standing position.
(fracture following minimal trauma)
Presence of fragility fracture defines osteoporosis regardless of the T-score.
True or false?
True
Are T-scores alone adequate to predict the risk for fragility fractures?
No
Should you diagnosis osteoporosis in younger patients based on their T-scores?
No
Are patients with inflammatory bowel disease or celiac disease at increased risk of osteoporosis and fragility fractures?
Yes
Is obesity protective against development of osteoporosis?
No
What does diabetes mellitus type 2 do to the risk of osteoporosis and fragility fracture?
Increases it
Some medications used to lower blood glucose in type 2 diabetes mellitus significantly increase the risk of osteoporosis and fragility fracture.
True or false?
True
What is a Colles’ fracture?
A common fragility fracture of the distal radius that occurs when a person falls on their outstretched arm.
Traverse fracture with dorsal displacement and angulation.
A parental history of non-hip fragility fracture may be a risk factor for fracture.
True or false?
True
Is a fragility fracture an indication for bone density testing?
Yes
Does pQCT of the forearm at the ultra-distal radius predict fragility fractures at the spine in post-menopausal women?
No
Do validated heel QUS devices predict fragility fractures in men over 65 years of age independently of central DXA BMD?
Yes
Do validated pDXA devices have stronger or weaker global fragility fracture predictive ability in post-menopausal women than central DXA and heel QUS?
Only vertebral fracture predictive ability is weaker
Does a BMC/BMD Z-score of higher than -2.0 in children preclude the possibility of skeletal fragility and increased fracture risk?
No - it does not
Typically how many years of bisphosphonate use is associated with low trauma atypical femur fractures?
More than 5 years
What imaging studies should be ordered when an atypical femur fracture is suspected?
Bilateral x-ray of the femurs with suspected atypical femur fracture, followed by an MRI or radionucleotide bone scan when clinical suspicion is high enough
What should you do with the bisphosphonates once an atypical femur fracture has occurred?
Stop the bisphosphonates
Has denosumab been associated with atypical femur fractures?
Yes - rarely
What are atypical femur fractures?
Low or no trauma fractures which are characterised by distinct radiologic and clinical features that are associated with long term use of potent anti-resorptive medications (distinguished from ordinary osteoporotic femoral diaphyseal fractures)
What are the distinct radiographic findings in atypical femur fractures?
- transverse fracture line
- periosteal callus formation at the fracture site
- little or no comminution
What are the distinct clinical features in atypical femur fractures?
- prodromal pain
- bilaterality
- resemble stress fractures
