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Glucocorticoid osteoporosis — SCE Rheumatology MCQ

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ModerateMetabolic bone diseaseGlucocorticoid osteoporosisSCE Rheumatology

A 55-year-old man with vasculitis is starting prednisolone 40 mg daily expected for 6 months. Examination shows no previous fracture is recorded. Investigations show vitamin D is borderline and FRAX risk is elevated. What is the most appropriate management?

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Correct answer: D — Start bone protection according to fracture risk

Start bone protection according to fracture risk is the most appropriate management because it addresses the underlying metabolic bone risk. The alternatives either do not prevent fracture, treat a different disease, or delay necessary intervention. Fracture prevention should begin promptly after fragility fracture or high-risk glucocorticoid exposure.

Reference: NOGG osteoporosis guideline; NICE CG146; BNF