The Fracture Cascae Importance of Secondary Prevention of 二级预防骨折的级联的重要性.pptVIP

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The Fracture Cascae Importance of Secondary Prevention of 二级预防骨折的级联的重要性.ppt

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The Fracture Cascae Importance of Secondary Prevention of 二级预防骨折的级联的重要性

Controversies in the Diagnosis and Management of Osteoporosis David A. Hanley, MD, FRCPC Professor, Department of Medicine Division of Endocrinology Metabolism University of Calgary Medical Director, CHR Osteoporosis Centre Disclosures Advisory Boards: Merck Frosst Canada, Proctor and Gamble Canada, Eli Lilly Canada, Novartis, NPS Pharmaceuticals Clinical Trials: Merck Frosst Canada, Proctor and Gamble Canada, Aventis, Eli Lilly Canada, Novartis, Pfizer, Amgen, Roche, NPS Pharmaceuticals, Wyeth -Ayerst I have received honoraria for speaking from most of the above companies Member of Executive Scientific Advisory Committee for Dairy Farmers of Canada (research grant reviews) I do not own shares in any pharmaceutical company I am not speaking as an official of the University of Calgary Controversies in the Diagnosis and Management of Osteoporosis Importance of Osteoporosis Guidelines, Algorithms Management of Osteopenia vs. Osteoporosis Testing, Newer Therapies Are Bisphosphonates Safe for Long-Term Use? World Health Organization Expert Panel BMD Definition of Osteoporosis (1994) (Adopted in Osteoporosis Canada’s 1996/2002 Guidelines 1. Kanis JA, et al. J Bone Miner Res 1994;9:1137-1141. 2. WHO technical document, Geneva 1994. Osteopenia? A term describing apparent decreased bone on X-ray Definition of Osteoporosis 2001 Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fracture. Bone strength primarily reflects the integration of bone density and bone quality. Osteoporosis is a Combination of Low Bone Density and Poor Bone Quality We have good measurements of bone density At present our best index of poor bone quality and osteoporosis is a previous fragility fracture* (just like coronary artery disease is best predicted by a previous myocardial infarct) Fragility fracture = low trauma, eg. a fall from a standing height or less “Normal bones don’t break” - Linda Mrkonjic