In this episode of The Good GP, Dr Krystyna de Lange is joined by Tasmanian General Practitioner and medical educator Dr Karen McGraith for a two-part series on osteoporosis. Discussing on the current Australian approaches to osteoporosis screening, assessment, and diagnosis, with emphasis on practical considerations for GPs.

Dr McGraith outlines the latest guidelines from the RACGP and Healthy Bones Australia, including distinctions between population screening and case finding for osteoporosis. Providing criteria for bone density assessment, such as age thresholds, specific medical conditions, and medication use. Identifying patients with minimal trauma fractures is highlighted, as well as groups who may be at high risk due to factors like glucocorticoid use, early menopause, and various systemic diseases.

They also discussed the use of risk assessment tools, namely the FRAX and Garvan calculators, to better predict fracture risk in patients with non-modifiable and lifestyle-related factors. Dr McGraith also provides a clear overview on interpreting bone mineral density (BMD) reports, including the significance of T-scores and Z-scores and when to investigate for secondary causes of osteoporosis.

Dr McGraith emphasises patient education and non-pharmacological management strategies, including nutrition (adequate calcium and protein intake), vitamin D sufficiency, exercise (resistance, impact, and balance training), and falls prevention.

Links & Resources:

• Healthy Bones Australia fact sheets - https://healthybonesaustralia.org.au/your-bone-health/
• Australasian Menopause Society Practitioners Toolkit for the Management of Menopause - https://www.menopause.org.au/hp/information-sheets/practitioners-toolkit-for-management-of-the-menopause
• RACGP and Healthy Bones Australia Clinical Guidelines - https://healthybonesaustralia.org.au/health-care-professionals/guidelines-statements/

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