Question

A 67-year-old woman with no prior fractures and no major comorbidities presents for a periodic health examination. She asks about screening to prevent osteoporotic fractures. According to the 2023 CTFPHC guideline on fragility fractures, what is the most appropriate first step?

Accepted Answer

Use the Canadian FRAX tool without BMD to estimate her 10-year fracture risk and then discuss pharmacotherapy if her risk is high

Answer

Order a bone mineral density (BMD) test for all women over 65 years

Answer

Avoid any screening unless she has had a low-trauma fracture

Answer

Start bisphosphonate therapy empirically because of her age

Answer

Order annual spine X-rays to screen for vertebral fractures

Practice question

A 67-year-old woman with no prior fractures and no major comorbidities presents for a periodic health examination. She asks about screening to prevent osteoporotic fractures. According to the 2023 CTFPHC guideline on fragility fractures, what is the most appropriate first step?