When should you screen for osteoporosis – and what should you do when you find it?

In this episode, hosts Dr. Meredith Chiasson and Dr. Peter Gregory speak with Dr. Vicki Munro, endocrinologist with Nova Scotia Health and assistant professor of medicine at Dalhousie University, about practical approaches to identifying patients at risk for fragility fractures and managing osteoporosis in everyday clinical care.

Dr. Munro explains how clinicians can recognize at-risk patients, when bone density testing is most helpful, and how to interpret risk factors such as glucocorticoid exposure, family history, and comorbid disease. She also reviews current treatment strategies, including when to consider bisphosphonates, anabolic therapies, and referral to specialty care.

Listeners will gain insights into:

• Key clinical clues that should prompt osteoporosis screening
• Risk factors that may warrant earlier testing than age-based screening alone
• Lifestyle and prevention strategies to support bone health
• When to initiate pharmacologic therapy – and when to consider specialist referral

Show notes (timestamps):

• 08:10 – Morin, Suzanne N., Sidney Feldman, Larry Funnell, et al. "Clinical Practice Guideline for Management of Osteoporosis and Fracture Prevention in Canada: 2023 Update." Canadian Medical Association Journal 195, no. 39 (2023): E1333–48. https://doi.org/10.1503/cmaj.221647.

• 14:15 – Khan, Aliya A., Hajar Abu Alrob, Dalal S. Ali, Karel Dandurand, Wendy Wolfman, and Michel Fortier. "Guideline No. 422g: Menopause and Osteoporosis." Journal of Obstetrics and Gynaecology Canada44, no. 5 (2022): 527-536.e5. https://doi.org/10.1016/j.jogc.2021.09.013.

• 18:25 – Humphrey, Mary Beth, Linda Russell, Maria I. Danila, Howard A. Fink, Gordon Guyatt, Michael Cannon, Liron Caplan, et al. "2022 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid‐Induced Osteoporosis." Arthritis Care & Research 75, no. 12 (December 2023): 2405–19

Clinical Currents is produced by the Dalhousie Department of Medicine for internal medicine physicians across the Maritimes. This podcast is for professional education only and should not be taken as personal medical advice. Content reflects Canadian practice unless otherwise noted.