My name is Fernando Florido and I am a GP in the United Kingdom. In today’s episode I review the NICE Clinical Knowledge Summaries (CKS) “Osteoporosis - prevention of fragility fractures” looking at both scenarios assessment and management, last updated in April 2023. I have summarised the guidance from a Primary Care perspective.


By way of disclaimer, I am not giving medical advice; this video is intended for health care professionals, it is only my interpretation of the guidelines and you must use your clinical judgement.  


There is a YouTube version of this and other videos that you can access here: 

• The NICE GP YouTube Channel: NICE GP - YouTube ([ Ссылка ])  





The summary on Osteoporosis - prevention of fragility fractures can be found here:


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The CKS “Osteoporosis - prevention of fragility fractures: Scenario: Assessment” can be found here:


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The CKS “Osteoporosis - prevention of fragility fractures: Scenario: Management” can be found here:


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The “Osteoporosis - prevention of fragility fractures: Prescribing information” can be found here:


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To calculate dietary calcium intake, see the National Osteoporosis Foundation chart:


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Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release]   

• Music provided by Audio Library Plus  

 

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Transcript 


Hello everyone and welcome. I am Fernando Florido, a GP in the United Kingdom.


Today, we'll be reviewing the NICE Clinical Knowledge Summaries (CKS) on “Osteoporosis - prevention of fragility fractures” looking at two scenarios, assessment and management, both updated in April 2023. I have summarised the guidance from a Primary Care perspective and I have put links in the episode description.


Please note that this is my interpretation of the guidelines, not medical advice. Always use your clinical judgement when treating your patients.


If you prefer a video format, there’s also a YouTube version of these episodes. The link is in the episode description.


Please stay until the end, as I'll be sharing fictitious clinical cases created by chat GPT that will illustrate how the guideline is applied in real-life situations.


So, with that said, let's dive in!"


The video has three parts, assessment, management and prescribing information.

• Osteoporosis is characterised by low bone mass and increased bone fragility and it is asymptomatic until a fracture occurs.
• A fragility fracture is a fracture following a fall from standing height or less, typically in the wrist, spine, and hip. Vertebral fractures may occur spontaneously
• Risk factors for osteoporosis include:
• Female sex.
• Increasing age.
• Menopause.
• Oral corticosteroids.
• Smoking and excess alcohol.
• Previous fragility fracture and Parental history of hip fracture
• Inflammatory arthropathies, such as rheumatoid arthritis and
• Body mass index of less than 18.5 kg/m2.

How should we assess a person for fragility fracture risk?

• First, we need to exclude other causes like:
• Metastatic bone disease
• Multiple myeloma
• Osteomalacia and
• Paget's disease and
• Also exclude secondary causes of osteoporosis like:
• Endocrine conditions such menopause, hypogonadism, diabetes mellitus, and hyperthyroidism.
• Inflammatory arthropathies such as rheumatoid arthritis.
• Gastrointestinal malabsorption like in Crohn's disease, ulcerative colitis, coeliac disease, and chronic pancreatitis. 
• Chronic conditions like chronic liver disease and COPD and
• We will then assess for vitamin D deficiency and inadequate calcium intake, especially if they are over 65 ...

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