Methods: All consecutive patients presenting at the Fracture Liaison Service (FLS) with a recent clinical vertebral or non-vertebral fracture were included. Fractures were categorised according to Center (1). DXA was performed and vertebral fractures were assessed. A semi-quantitative scoring was performed according to Genant into grade 0-3. A vertebral fracture (VF) in this study was defined as a VF grade 2 or 3. Laboratory tests were performed (serum calcium, phosphate, 25(OH)D, protein electrophoresis, creatinine, PTH, TSH, and in men < 70 years serum testosterone].
Results: Between May 2012 and October 2013, 945 patients presented with a recent clinical fracture (71.0% women, mean age 65.9±9.9 years). Of 93 patients (9.8%) with a clinical VF, 46.2% had osteoporosis and 40.9% osteopenia. At least one new contributor to SECondary Osteoporosis and metabolic Bone disease (SECOB) was found in 25 patients (27.5%). Of 852 patients presenting with a non-vertebral fracture, 254 (29.8%) had osteoporosis, 438 (51.4%) osteopenia and 160 (18.8%) a normal BMD. Of the patients with osteoporosis, 15.4% had a hip, 19.3% a major, 48.8% a minor and 16.5% a finger/toe fracture. These % were 4.8%, 19.2%, 50.0% and 26.0% in patients with osteopenia and 4.4%, 13.1%, 59.4% and 23.1% in patients with normal BMD. At least 1 VF was found in 153 patients (17.9%), in 26.8%, 15.3% and 11.3% of patients with osteoporosis, osteopenia and normal BMD respectively (p<0.0001). New SECOB was found in 23.5%, 23.8% and 20.0% of patients with osteoporosis, osteopenia and normal BMD.
Conclusion: At presentation at the FLS, nearly 10% of patients had a clinical VF and 27% of them had SECOB. In patients presenting with a non-vertebral fracture, VFs were more frequently found in patients with osteoporosis than in patients with osteopenia or normal BMD. New SECOB on the other hand was present in 23% of all patients, independent of BMD.
Disclosure: The authors declared no competing interests.