Osteoarthritis Flashcards
How would you assess the future fracture risk in an elderly patient following a fall?
FRAX (10 year risk of a fracture) or QFRACTURE tool as a first line to determine if treatment (high risk), DEXA scan (moderate risk) or lifestyle advice (low risk) are most appropriate course of action
What risk factors are considered in osteoporosis?
They advise that all women aged >= 65 years and all men aged >= 75 years should be assessed. Younger patients should be assessed in the presence of risk factors, such as:
previous fragility fracture
current use or frequent recent use of oral or systemic glucocorticoid
history of falls
family history of hip fracture
other causes of secondary osteoporosis
low body mass index (BMI) (less than 18.5 kg/m²)
smoking
alcohol intake of more than 14 units per week for women and more than 14 units per week for men.
When might a DEXA scan as a first line be indicated?
before starting treatments that may have a rapid adverse effect on bone density (for example, sex hormone deprivation for treatment for breast or prostate cancer).
in people aged under 40 years who have a major risk factor, such as history of multiple fragility fracture, major osteoporotic fracture, or current or recent use of high-dose oral or high-dose systemic glucocorticoids (more than 7.5 mg prednisolone or equivalent per day for 3 months or longer).
Beyond time period of morning stiffness would warrant a consideration of RA over OA?
More than 2 hours of morning stiffness should consider RA.
