Osteoporosis is characterised by low bone mineral density and micro-architectural deterioration of bone leading to an increased risk of low-trauma fractures, associated morbidity and mortality. This article describes the advances in imaging of osteoporosis including opportunistic identification of low bone density and vertebral fractures.
Patients’ length of hospital stay greatly varies between NHS trusts. By reviewing and improving admission and discharge processes, trusts can improve the patient experience by reducing the number of days spent in hospital. In return, trusts can save bed days, thus increasing capacity and saving money.
Assessment of older people with frailty through Comprehensive Geriatric Assessment is known to improve outcomes, including mortality in hospital and the community. The inpatient Older People’s Advice and Liaison service at the Royal Surrey County Hospital was created to improve access to specialist geriatric input across non-geriatrician led wards.
The role of vitamin D in the management of osteoporosis came under the spotlight recently after a study reviewed the results of 81 research trials of people aged 18 or over taking vitamin D supplements. It found no reduction in fractures or falls and no improvement in bone density in people taking the supplements and recommeded guidelines were adapted.
Over the years male osteoporosis has received little attention. One in eight men older than 50 years will have a fragility fracture during their lifetime, which will contribute to dependency, morbidity and a higher mortality in the first year.1 Although the rate of bone loss in men is slower,2 the mortality risk is twice after a hip fracture when compared to women.3