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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/8531

Title: Evaluation of patients with a recent clinical fracture and osteoporosis, a multidisciplinary approach
Authors: Dumitrescu, Bianca
van Helden, Svenjhalmar
ten Broeke, Rene
Nieuwenhuijzen-Kruseman, Arie
Wyers, Caroline
Udrea, Gabriela
van der Linden, Sjef
GEUSENS, Piet
Issue Date: 2008
Publisher: BIOMED CENTRAL LTD
Citation: BMC MUSCULOSKELETAL DISORDERS, 9
Abstract: The aetiology of osteoporotic fractures is multifactorial, but little is known about the way to evaluate patients with a recent clinical fracture for the presence of secondary osteoporosis. The purpose of this study was to determine the prevalence of contributors to secondary osteoporosis in patients presenting with a clinical vertebral or non-vertebral fracture. Identifying and correcting these contributors will enhance treatment effect aimed at reducing the risk of subsequent fractures. In a multidisciplinary approach, including evaluation of bone and fall-related risk factors, 100 consecutive women (n = 73) and men (n = 27) older than 50 years presenting with a clinical vertebral or non-vertebral fracture and having osteoporosis (T-score <=-2.5) were further evaluated clinically and by laboratory testing for the presence of contributors to secondary osteoporosis. In 27 patients, 34 contributors were previously known, in 50 patients 52 new contributors were diagnosed (mainly vitamin D deficiency in 42) and 14 needed further exploration because of laboratory abnormalities (mainly abnormal thyroid stimulating hormone in 9). The 57 patients with contributors were older (71 vs. 64 yrs, p < 0.01), had more vertebral deformities (67% vs. 44%, p < 0.05) and a higher calculated absolute 10-year risk for major (16.5 vs. 9.9%, p < 0.01) and for hip fracture (6.9 vs. 2.4%, p < 0.01) than patients without contributors. The presence of contributors was similar between women and men and between patients with fractures associated with a low or high-energy trauma. We conclude that more than one in two patients presenting with a clinical vertebral or non-vertebral fracture and BMD-osteoporosis have secondary contributors to osteoporosis, most of which were correctable. Identifying and correcting these associated disorders will enhance treatment effect aimed at reducing the risk of subsequent fractures in patients older than 50 years.
Notes: Univ Hosp, Dept Internal Med, Subdiv Rheumatol, Maastricht, Netherlands. Univ Med & Pharm Carol Davila Bucharest, Dept Rheumatol, Bucharest, Romania. Univ Hosp, Dept Trauma Surg, Maastricht, Netherlands. Univ Hosp, Dept Orthopaed Surg, Maastricht, Netherlands. Univ Hosp, Dept Internal Med, Div Endocrinol, Maastricht, Netherlands. Maastricht Univ, Maastricht, Netherlands. Univ Hasselt, Biomed Res Ctr, Diepenbeek, Belgium.
URI: http://hdl.handle.net/1942/8531
DOI: 10.1186/1471-2474-9-109
ISI #: 000259320200001
ISSN: 1471-2474
Category: A1
Type: Journal Contribution
Validation: ecoom, 2009
Appears in Collections: Research publications

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