Bone has the ability to adapt its shape and size in response to mechanical loads via a process known as modelling in which bones are shaped or reshaped by the independent action of osteoblasts and osteoclasts. Remodelling is a process that maintains mechanical integrity of the skeleton, allowing it to selectively repair and replace damaged bone. During adulthood, bone remodelling is the dominan...

Introduction Metabolic bone disease is a malady that causes significant morbidity and mortality to a patient who has sustained a fragility fracture. There is currently no protocol to prevent secondary fragility fracture at our institution. The objective of this study was to create an appropriate protocol for implementing clinical pathways for physicians to diagnose and treat osteoporosis and fr...

This article provides an overview of the current burden of osteoporosis and its complications in today's health care system. The impact of osteoporosis on patients' quality of life and direct financial consequences to the entire health care system are emphasized to highlight the need for increased knowledge and awareness of its complications if left untreated or treated incorrectly. Special att...

Context: Primary hyperparathyroidism (PHPT) is commonly associated with reduced bone mineral density (BMD) presenting with osteoporosis, increasing the risk of bone fragility fractures in these patients. Bisphosphonates, due to their anti-resorptive action, are known to improve the BMD and reduce the risk of bone fragility fractures. Therefore, bisphosphonates are considered as an alternative t...

OBJECTIVES To describe practice patterns in the management of osteoporosis after fragility fracture. METHODS Systematic review of articles in MEDLINE, EMBASE, Cochrane, and CINAHL databases (1996 to February 2005). Diagnostic outcomes included clinical osteoporosis diagnoses, laboratory tests, and bone density scans. Treatment outcomes included initiation of calcium, vitamin D, hormone replac...

OBJECTIVE This study aimed to estimate the association of frailty with incidence and mortality of fractures at different sites in people aged over 80 years. DESIGN Cohort study. SETTING UK family practices from 2001 to 2014. PARTICIPANTS 265 195 registered participants aged 80 years and older. MEASUREMENTS Frailty status classified into 'fit', 'mild', 'moderate' and 'severe' frailty. Fr...

INTRODUCTION In setting up a disease registry for fragility fractures in Hong Kong, we conducted a retrospective systematic study on the management of fragility hip fractures. Patient outcomes were compared with the standards from our orthopaedic working group and those from the British Orthopaedic Association that runs a mature fracture registry in the United Kingdom. METHODS Clinical data o...

Fragility fractures represent a major health care issue that is associated with substantial morbidity, mortality, and health care costs. Pharmacologic therapy is effective in lowering the risk of further fractures by 30%-70%, but there is a major care gap, as <20% of patients with fragility fractures are started on pharmacotherapy [1]. Radiologists are in a key position to close the care gap by...

Correspondence: Paula Rackoff Beth Israel Medical Center, 10 Union Square east, Suite 3D, New York, NY 10003, USA email [email protected] Abstract: Fragility fractures that occur as a result of osteoporosis are frequently associated with chronic pain and decreased quality of life as well as significant morbidity and mortality. Fracture reduction, however, is often less than optimal due to poo...

This is one of a series of BMJ summaries of new guidelines based on the best available evidence; they highlight important recommendations for clinical practice, especially where uncertainty or controversy exists. Further information about the guidance, a list of members of the guideline development group, and the supporting evidence statements are in the full version on bmj.com. Who needs risk ...