Clinical Updates - Identifying Osteoporosis-Related Vertebral Fractures in Primary Care
Vertebral compression fractures (VCF) are the most common osteoporosis-related fractures. They are also the most easily overlooked. Because they can be asymptomatic, VCFs are difficult to recognize until extensive, irreversible damage has been done. Whether symptomatic or silent, VCFs predict future skeletal deterioration. Identifying these sentinel fractures in patients at risk enables the clinician to stop the fracture cascade before it gets going and thereby preserve a patient’s skeletal health. In this article, the first of two on the subject, we explore the critical topic of osteoporosis-related vertebral fracture -- both how to diagnose these fractures and how to distinguish them from the many other causes of back pain. Fee: Member-$0; Nonmember-$10
Initial Date: December 1, 2019
Expiration Date: December 31, 2021
Credits Available: 1.0 hour
Fee: Member-$0; Nonmember-$10

-Angelo Licata, MD, PhD: Nothing to Disclose
-Mary Beth O'Connell, PharmD, BCPS: Honorarium-American Society of Consultant Pharmacists
-Adrienne Berarducci, PhD, ARNP, BC: Nothing to Disclose
-Peggy Doheny, PhD, RN: Nothing to Disclose
-Avery Jackson, MD: Nothing to Disclose
-Craig Langman, MD: Consultant-Dicerna Pharma, Incyte Pharma, and Allena Pharma
-Jeri Nieves, PhD: Grant/Research-Eli Lilly
-Rick Pope, MPAS, PA-C: Nothing to Disclose
-Susan Randall, MSN, RN, FNP-BC: Nothing to Disclose
-Carol Sedlack, PhD, RN: Nothing to Disclose
-Andrea Sikon, MD: Nothing to Disclose
-Andrea Singer, MD: -Andrea Singer, MD: Research-Radius Health, UCB; Consulting-Agnovos, Amgen, Eli Lilly, Merit, Radius Health, UCB; Speaker's Bureau-Amgen, Eli Lilly, Radius Health; Board-NOF
-Kelly Trippe, MA: Nothing to Disclose
-Robert Westergan, MD: Nothing to Disclose

Support for this activity was received from Medtronic.

Activity Description
Vertebral compression fractures pose numerous distinct threats to health, longevity, and quality of life. When concentrated in the thoracic spine, VCFs contribute to restrictive lung disease and cardiac compromise. Fractures in the lumbar spine lead to constipation, abdominal distention, and weight loss. Spinal deformity caused by multiple fractures increases risk for falls and impedes ambulation by impairing balance and gait. And, when chronic back pain restricts a patient’s activities, the complications of immobility ensue – pneumonia, deep vein thrombosis, deconditioning, and bone loss. One fracture begets another, too often culminating in disability, deformity, and premature death.

In this article, the first of two on the subject, we explore the critical topic of osteoporosis related vertebral fracture. We discuss the factors that lead to pathologic changes in the spine, the types of fractures that result, their consequences to physical and psychological health, and both how to diagnose these fractures and how to distinguish them from the myriad other causes of back pain. In the second article, we will discuss the spectrum of therapeutic options for VCF and the growing evidence base that clinicians can draw upon when developing management plans for affected patients.

Target Audience
This continuing education activity is intended for use by health professionals who participate in the care of patients at risk for or suffering from osteoporosis, in the areas of primary care, endocrinology, geriatrics, gynecology, internal medicine, obstetrics, orthopedics, osteopathy, pediatrics, physiatry, radiology, rheumatology and physical therapy.

This includes physicians, nurse practitioners, registered nurses, pharmacists, physician assistants, technologists, researchers, public health professionals and health educators with an interest in osteoporosis and bone health.

Upon completion of this CME material, the participant should be able to:

1) Identify signs and symptoms of vertebral compression fracture (VCF), whether acute, healed, or “silent" (asymptomatic). 

2) Differentiate vertebral compression fractures from other causes of back pain.
3) Assess risk for vertebral compression fractures in individual patients.
4) Describe the significance of vertebral compression fractures in terms of morbidity and mortality.
5) Recognize and rule out non-osteoporosis secondary causes of bone loss and fractures.

The National Osteoporosis Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The National Osteoporosis Foundation designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

The National Osteoporosis Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The National Osteoporosis Foundation designates this educational activity for a maximum of 1.0 continuing nursing education credit(s).

Other healthcare providers will also be able to receive a certificate of completion; nurse practitioners and physician assistants may request an AMA PRA Category 1 Credit(s)™ certificate of participation.

CME Program Eligibility
Method of Participation in the Learning Process: Clinician learners will read and analyze the subject matter, conduct additional informal research through related internet searches on the subject matter, and complete a post-test assessment of knowledge and skills gained as a result of the activity.

After participating in this activity, the reader has the option of taking a post-test with a passing grade of 70% or better to qualify for continuing education credit for this activity. It is estimated it will take 1.0 hour(s) to complete the reading and take the post-test. Continuing education credit will be available for two years from the date of publication.

Disclosure of Commercial Support
It is the policy of the National Osteoporosis Foundation (NOF) to ensure balance, independence, objectivity, and scientific rigor in all its sponsored publications and programs. NOF requires the disclosure of the existence of any significant financial interest or any other relationship the sponsor, Editorial Board or Guest Contributors have with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. All authors and contributors to this continuing education activity have disclosed any real or apparent interest that may have direct bearing on the subject matter of this program.

Please be advised that NOF’s accreditation status with ACCME and ANCC does not imply endorsement by NOF, ACCME or ANCC of any commercial products displayed in conjunction with this activity or endorsement of any point of view.

Statement regarding OFF Label Use

Please be advised that any publication of the Osteoporosis Clinical Updates that discusses off-label use of any medications or devices will be disclosed to the participant.

Refund Policy
NOF offers no returns or refunds on online internet CME activities purchased through our store. All sales are final. Meeting and workshop registrations will be refunded in accordance with the cancellation policy of the meeting and/or workshop, as outlined at registration.

Type:     Internet Activity (Enduring Material)
40 Registered Users

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