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Treatment Without DXA Fragility Fracture — SCE Rheumatology MCQ

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HardMetabolic Bone DiseaseTreatment Without DXA Fragility FractureSCE Rheumatology

A 72-year-old woman has a radiographically confirmed vertebral fragility fracture and very high future-fracture risk. What is the role of DXA before treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Begin treatment and use DXA when it refines management

The best answer is “Begin treatment and use DXA when it refines management”. A recent vertebral fragility fracture signals high imminent risk, so clinically indicated anti-osteoporosis treatment should not be delayed solely to obtain DXA. Bone density can still refine risk, provide a baseline or influence treatment choice. It is not universally mandatory, restricted to advanced age, permanently uninformative or dependent on a second fracture.

Reference: NOGG intervention thresholds and strategy: https://www.nogg.org.uk/full-guideline/section-4-intervention-thresholds-and-strategy