Osteoporotic Fractures: Diagnosis, Evaluation, and Significance From the International Working Group on DXA Best Practices.

Autor:	Khan AA; Division of Endocrinology and Metabolism, McMaster University, Hamilton, Ontario, Canada. Electronic address: aliya@mcmaster.ca., Slart RHJA; University Medical Center Groningen, Medical Imaging Centre, Department of Nuclear Medicine and Molecular Imaging, Groningen, The Netherlands., Ali DS; Division of Endocrinology and Metabolism, McMaster University, Hamilton, Ontario, Canada., Bock O; Department of Osteoporosis, Inselspital, Bern University Hospital, Switzerland, IG Osteoporose, Bern, Switzerland., Carey JJ; Department of Rheumatology, University of Galway, Galway, Ireland., Camacho P; Loyola University-Stritch School of Medicine, Maywood, IL., Engelke K; Department of Medicine 3 and Institute of Medical Physics, FAU University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Germany., Erba PA; Department of Medicine and Surgery, Nuclear Medicine UnitASST, Ospedale Papa Giovanni, University of Milan-Bicocca, Piazza, Bergamo, Italy., Harvey NC; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital NHS Foundation Trust, Southampton, UK., Lems WF; Department of Rheumatology, Amsterdam University Medical Center, The Netherlands., Morgan S; Osteoporosis Prevention and Treatment Center and DXA Facility, University of Alabama at Birmingham, Birmingham, AL., Moseley KF; Johns Hopkins University, Baltimore, MD., O'Brien C; Brant Community Healthcare System, Brantford, Ontario, Canada., Probyn L; Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Punda M; Department of Oncology and Nuclear Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia., Richmond B; Musculoskeletal Radiology, Cleveland Clinic, Cleveland, OH., Schousboe JT; Division of Health Policy and Management, University of Minnesota, Minneapolis, MN., Shuhart C; Swedish Bone Health and Osteoporosis Center, Seattle, WA., Ward KA; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital NHS Foundation Trust, Southampton, UK., Lewiecki EM; New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM.
Jazyk:	angličtina
Zdroj:	Mayo Clinic proceedings [Mayo Clin Proc] 2024 Jul; Vol. 99 (7), pp. 1127-1141.
DOI:	10.1016/j.mayocp.2024.01.011
Abstrakt:	Osteoporotic fractures, also known as fragility fractures, are reflective of compromised bone strength and are associated with significant morbidity and mortality. Such fractures may be clinically silent, and others may present clinically with pain and deformity at the time of the injury. Unfortunately, and even at the time of detection, most individuals sustaining fragility fractures are not identified as having underlying metabolic bone disease and are not evaluated or treated to reduce the incidence of future fractures. A multidisciplinary international working group with representation from international societies dedicated to advancing the care of patients with metabolic bone disease has developed best practice recommendations for the diagnosis and evaluation of individuals with fragility fractures. A comprehensive narrative review was conducted to identify key articles on fragility fractures and their impact on the incidence of further fractures, morbidity, and mortality. This document represents consensus among the supporting societies and harmonizes best practice recommendations consistent with advances in research. A fragility fracture in an adult is an important predictor of future fractures and requires further evaluation and treatment of the underlying osteoporosis. It is important to recognize that most fragility fractures occur in patients with bone mineral density T scores higher than -2.5, and these fractures confirm the presence of skeletal fragility even in the presence of a well-maintained bone mineral density. Fragility fractures require further evaluation with exclusion of contributing factors for osteoporosis and assessment of clinical risk factors for fracture followed by appropriate pharmacological intervention designed to reduce the risk of future fracture. Because most low-trauma vertebral fractures do not present with pain, dedicated vertebral imaging and review of past imaging is useful in identifying fractures in patients at high risk for vertebral fractures. Given the importance of fractures in confirming skeletal fragility and predicting future events, it is recommended that an established classification system be used for fracture identification and reporting. (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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