Osteoporosis / osteopenia consult

BMD review Post-fracture Start therapy Therapy review Counselling Other

None identified Prior fracture Parent hip # Early menopause Glucocorticoids Low body weight Smoker Alcohol Falls Low mobility Comorbidity

None Height loss Kyphosis Back pain Thigh/groin pain

Normal Osteopenia Osteoporosis Very high risk No DXA

No vertebral # Vertebral # Imaging arranged

Not calculated Below threshold High Very high

Negative Pending Vit D low Identified

Exercise Calcium Vitamin D Falls review Smoking Alcohol Dental Exercise referral Falls clinic

Not indicated Alendronate Risedronate Zoledronic Denosumab Raloxifene MHT Continue current Specialist referral Other

Ca diet adequate Vit D daily Vit D high dose Ca supplement Combo tablet

Adherence Dental Administration Denosumab timing Zoledronic flu Hypocalcaemia Musculoskeletal Atypical # GI Fact sheets

Review 3–6/12 DXA 2 yr Pre-dose bloods Bloods 3/12 GC BMD 1–2 yr Falls plan