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The silent, stealthy nature of osteoporosis makes it one of medicine's most challenging conditions. Patients can lose precious bone mass for years with absolutely no symptoms, only discovering their condition after a devastating, life-altering fracture.

With over a million Australians affected and our population steadily aging, understanding how to identify, investigate and treat this condition couldn't be more crucial. Yet despite its prevalence, osteoporosis remains severely underdiagnosed and undertreated in clinical practice.

In this comprehensive episode, Dr Gavin Nimon ( host and Orthopaedic Surgeon) inteviews Endocrinologist Dr Linn Lee brings about this complex topic. She expertly guides us through interpreting those notoriously confusing DEXA scan reports, breaking down T-scores and Z-scores into practical insights you can immediately apply. You'll discover exactly who needs investigating, when to refer to specialists, and how various risk assessment tools like FRAX and Garvan calculators can quantify fracture risk beyond bone density measurements alone.

Dr Lee demystifies the expansive pharmacological landscape – from bisphosphonates to cutting-edge anabolic agents – with particular attention to selecting the right medication for specific patient profiles. She discusses potential complications like osteonecrosis and atypical femoral fractures with refreshing honesty, providing evidence-based context about their prevalence and management strategies to mitigate risks.

Perhaps most valuable is the practical guidance on monitoring treatment efficacy, managing medication side effects, and navigating challenging clinical scenarios like bisphosphonate "drug holidays" and the complexities of stopping denosumab. The discussion extends beyond medications to emphasize the critical role of calcium, vitamin D, and targeted exercise regimens in comprehensive bone health management.

Whether you're a medical student building your foundational knowledge or an experienced GP managing complex cases, this episode delivers the practical insights you need to provide optimal care for patients with this prevalent but often overlooked condition. Subscribe to Aussie Med Ed for more expert-led, pragmatic discussions on core medical topics.

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