Closing the Osteoporosis Care Gap | Geriatrics | JN Learning | AMA Ed Hub [Skip to Content]
[Skip to Content Landing]

Closing the Osteoporosis Care GapA Teachable Moment

Educational Objective
To describe the rationale for appropriate treatment of osteoporosis after a patient's initial fragility fracture and the practice gap in doing so.
1 Credit CME

A 91-year-old woman presented to the hospital with right-sided hip pain after losing balance and falling from standing height. On examination, her right leg was shortened and externally rotated. There was pain in the right groin and hip with movement. A radiogram of her right hip and pelvis revealed a peritrochanteric fracture. She was taken urgently to the operating room, where she underwent an open reduction and internal fixation.

The patient presented to her primary care physician 2 years prior with lower back pain immediately after a fall from standing height. A radiogram of the lumbar spine at that time demonstrated a compression fracture of L5. She was diagnosed with an acute atraumatic vertebral fracture and given a prescription for analgesia. While the patient had an uncomplicated recovery from surgery, she and her daughter wondered what could have been done to prevent this hip fracture.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: William K. Silverstein, MD, Department of Medicine, University of Toronto, 2075 Bayview Ave, D-416B, Toronto, ON M4N 3M5, Canada (william.silverstein@mail.utoronto.ca).

Conflict of Interest Disclosures: Dr Zipursky reported payments from private law firms for medicolegal opinions regarding the safety and effectiveness of drugs outside the submitted work. No other disclosures were reported.

Additional Contributions: We thank Govind Warrier, MD, MPH, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University for his editorial assistance. He was not compensated for his contributions. We also thank the patient’s daughter for granting permission to publish this information.

Published Online: October 18, 2021. doi:10.1001/jamainternmed.2021.5972

References
1.
Compston  JE , McClung  MR , Leslie  WD .  Osteoporosis.   Lancet. 2019;393(10169):364-376. doi:10.1016/S0140-6736(18)32112-3PubMedGoogle ScholarCrossref
2.
Eastell  R , Rosen  CJ , Black  DM , Cheung  AM , Murad  MH , Shoback  D .  Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society Clinical Practice Guideline.   J Clin Endocrinol Metab. 2019;104(5):1595-1622. doi:10.1210/jc.2019-00221PubMedGoogle ScholarCrossref
3.
Kanis  JA , Svedbom  A , Harvey  N , McCloskey  EV .  The osteoporosis treatment gap.   J Bone Miner Res. 2014;29(9):1926-1928. doi:10.1002/jbmr.2301PubMedGoogle ScholarCrossref
4.
Martin  J , Viprey  M , Castagne  B ,  et al.  Interventions to improve osteoporosis care: a systematic review and meta-analysis.   Osteoporos Int. 2020;31(3):429-446. doi:10.1007/s00198-020-05308-0PubMedGoogle ScholarCrossref
5.
Crandall  CJ , Larson  JC , LaCroix  AZ ,  et al.  Risk of subsequent fractures in postmenopausal women after nontraumatic vs traumatic fractures.   JAMA Intern Med. 2021;181(8):1055-1063. doi:10.1001/jamainternmed.2021.2617PubMedGoogle ScholarCrossref
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
Want full access to the AMA Ed Hub?
After you sign up for AMA Membership, make sure you sign in or create a Physician account with the AMA in order to access all learning activities on the AMA Ed Hub
Buy this activity
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close

My Saved Courses

You currently have no courses saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close