Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Consider referring a patient for specialist assessment in osteoporosis if they are at very high risk of fragility fracture. This includes people with:
- a recent vertebral fracture within the last 2 years,
- two or more vertebral fractures regardless of timing,
- a bone mineral density (BMD) T-score of -3.5 or lower,
- taking high-dose glucocorticoids (7.5 mg or more prednisolone daily or equivalent for over 3 months),
- multiple clinical risk factors, especially with a recent fragility fracture indicating high imminent risk of re-fracture,
- other indicators of very high fracture risk.
Additionally, refer younger patients (<40 years) with major risk factors such as high-dose corticosteroid use or previous major osteoporotic fractures to a specialist experienced in osteoporosis treatment.
Also consider specialist referral for patients with secondary causes of osteoporosis or complex underlying conditions contributing to bone fragility.