1.1
Consider assessment of fracture risk:
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in all women aged 65 years and over and all men aged 75 years and over
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in women aged under 65 years and men aged under 75 years in the presence of risk factors, for example:
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previous fragility fracture
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current use or frequent recent use of oral or systemic glucocorticoids
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history of falls
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family history of hip fracture
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other causes of secondary osteoporosis
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low body mass index (BMI; less than 18.5 kg/m2)
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smoking
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alcohol intake of more than 14 units per week for men and women.
Causes of secondary osteoporosis include endocrine (hypogonadism in either sex including untreated premature menopause and treatment with aromatase inhibitors or androgen deprivation therapy; hyperthyroidism; hyperparathyroidism; hyperprolactinaemia; Cushing's disease; diabetes), gastrointestinal (coeliac disease; inflammatory bowel disease; chronic liver disease; chronic pancreatitis; other causes of malabsorption), rheumatological (rheumatoid arthritis; other inflammatory arthropathies), haematological (multiple myeloma; haemoglobinopathies; systemic mastocytosis), respiratory (cystic fibrosis; chronic obstructive pulmonary disease), metabolic (homocystinuria), chronic renal disease and immobility (due for example to neurological injury or disease).
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