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Osteoporosis — SCE Rheumatology MCQ

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HardMetabolic Bone DiseaseOsteoporosisSCE Rheumatology

A 55-year-old woman has a FRAX-calculated 10-year probability of major osteoporotic fracture of 22% and hip fracture of 5.5%. She has no prior fractures and T-score is -1.8. According to NOGG guidance what intervention threshold determines treatment eligibility?

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Correct answer: E — Age-dependent FRAX intervention threshold compared with fracture probability of a same-age woman with prior fragility fracture

The best answer is “Age-dependent FRAX intervention threshold compared with fracture probability of a same-age woman with prior fragility fracture”. Age-dependent FRAX intervention threshold compared with fracture probability of a same-age woman with prior fragility fracture is supported by the cited UK or directly applicable specialist authority and best matches the tested threshold, complication or monitoring principle. The remaining choices—“Fixed FRAX threshold of 20% for all patients, after specialist assessment, with clinical reassessment, within a rheumatology pathway”, “Fixed FRAX threshold of 10%, with clinical reassessment, within a rheumatology pathway, after safety review”, “BMD measurement principally, after safety review, within a rheumatology pathway, after safety review, after specialist assessment”, “T-score ≤-2.5 across FRAX, after safety review, after specialist assessment, with clinical reassessment”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

Reference: NICE NG226 osteoarthritis: https://www.nice.org.uk/guidance/ng226/chapter/Recommendations