Prior to last year, this column was titled “Update on osteoporosis.” My observation, however, is that too many ObGyn providers simply measure bone mass (known as bone mineral density, or BMD), label a patient as normal, osteopenic, or osteoporotic, and then consider pharmacotherapy. The FRAX fracture prediction algorithm, which incorporates age, weight, height, history of any previous fracture, family history of hip fracture, current smoking, use of glucocorticoid medications, and any history of rheumatoid arthritis, has refined the screening process somewhat, if and when it is utilized. As clinicians, we should never lose sight of our goal: to prevent fragility fractures. Having osteoporosis increases that risk, but not having osteoporosis does not eliminate it.
In this Update, I highlight various ways in which work published this past year may help us to improve our patients’ bone health and reduce fragility fractures.
Updated ISCD guidance emphasizes appropriate BMD testing, use of the
Z-score, and terminology
International Society for Clinical Densitometry. 2019 ISCD Official Positions-Adult. June 2019. https://www.iscd.org/official-positions/2019-ISCD-official-positions-adult.
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