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More than 300 genetic variants have been discovered to be associated with osteoporosis or fracture. The magnitude of effect of these variants on fracture risk is very modest. One may ask: how can doctors utilise genes for fracture risk assessment? Consider the following case: a 70 year old woman whose femoral neck BMD is 0.72 …

Breakable bones and genes – How can doctors utilise genes for fracture risk assessment? Read More »

In December 2012, Osteoporosis New Zealand (ONZ) published BoneCare 2020 which called for implementation of a systematic approach to hip fracture care and prevention for New Zealand. This included establishing a national hip fracture registry to benchmark care against quality standards and nationwide implementation of Fracture Liaison Services (FLS), to ensure all people who sustain …

Innovative approaches to driving public awareness of bone health Read More »

Osteopenia is not a disease. It is a category of bone density – between 1 and 2.5 standard deviations below the mean value in the young normal population. Thus, one in six healthy young individuals have a bone density in this range, as do the majority of women over the age of 60 years. The …

Osteopenia – To treat or not to treat. That is the question Read More »

Since the term was coined by John McCarthy in 1956, Artificial Intelligence (AI), the ability of machines to emulate human cognition in the analysis, interpretation, and comprehension of complicated data, has come a long way. Earlier, in 1950, Alan Turing’s classic publication “Computing Machinery and Intelligence” had introduced the concept of what is now known as the …

Fixing a Fractured Future – Can Artificial Intelligence help? Read More »

The bone loss and increased bone fragility that results from specific, well-defined clinical disorders, and due to certain medications, is termed secondary osteoporosis. Pre- and post-menopausal women, as well as men, may develop secondary osteoporosis. Up to 45% of post-menopausal women, and 60-65% of men are found to have an underlying contributor to their osteoporosis …

Not just garden-variety osteoporosis: secondary osteoporosis and its management Read More »

A recent IOF-ISCD global survey carried out at the Medical Research Council Lifecourse Epidemiology Unit (MRC LEU, University of Southampton) in collaboration with the International Osteoporosis Foundation (IOF) and the International Society for Clinical Densitometry (ISCD), has revealed a worrying lack of quality assurance and reporting procedures in DXA services worldwide. Dual-energy X-ray absorptiometry (DXA) …

DXA scanning facility quality standards – Are we falling woefully short? Read More »

Osteoporosis is a silent and chronic disease. Many patients are unaware that they have the disease until they sustain a fracture. Nurses can be at the front line in helping to manage osteoporosis. Asian cultural norms favour an environment where the dependent relationship between parents and their children change inversely as persons get older, with …

Florence Nightingale in the Asia Pacific – the osteoporosis nurse and her role in battling the silent disease Read More »

Is obesity protective for fragility fractures due to osteoporosis? The answer, although complex, is likely to be no. While obesity defined by body mass index (BMI) is generally associated with higher areal bone mineral density (BMD) and a lower fracture risk, fracture risk at specific skeletal sites is actually increased. For example, the Global Longitudinal …

Obesity and osteoporosis Read More »

Falls lead to injury, and in some cases, fractures.  The cause of the fall needs to be carefully identified and appropriate interventions and investigations initiated to prevent further falls. Falls intervention does reduce falls and hospital admissions. The data on fracture reduction is not yet clear. Though existing literature remains inconsistent regarding the relationship between …

“A fracture begets a fracture” – The importance of timely diagnosis and initiation of osteoporosis therapy Read More »

Use of NHANES III reference range for bone mineral density (BMD) can result in an overdiagnosis of osteoporosis in Asians The diagnosis of osteoporosis is operationally based on a measurement of bone mineral density (BMD), preferably at the femoral neck or total hip. According to WHO’s recommendation, osteoporosis is defined as a BMD T-score of …

BMD Reference ranges for the diagnosis of osteoporosis in Asians – Time to rethink? Read More »