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Post-fracture osteoporosis — SCE Rheumatology MCQ

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ModerateMetabolic bone diseasePost-fracture osteoporosisSCE Rheumatology

A 76-year-old woman has a low-trauma distal radius fracture and high fracture risk on FRAX. Examination shows dental health is stable and she can sit upright. Investigations show eGFR is 58 mL/min/1.73m2 and calcium is normal. What is the most appropriate management?

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Correct answer: C — Start oral bisphosphonate with calcium and vitamin D optimisation

Start oral bisphosphonate with calcium and vitamin D optimisation 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