Fracture risk assessment service

Patients may be referred to the Metabolic Bone Centre for fracture risk assessment. All patients undergo a measurement of bone mineral density (BMD) of the spine and hip, using dual-energy x-ray absorptiometry (DXA). They are also asked to complete a questionnaire which identifies information from their medical history which may affect their bone health.

Further investigations are performed depending on the individual’s DXA results and risk factors. These may include:

  • an imaging scan (vertebral fracture assessment, VFA) which is obtained using the DXA scanner and allows us to identify the presence of vertebral fractures
  • spine x-rays – which will be used if the VFA scan suggests the presence of fractures
  • blood and urine tests to look for causes of osteoporosis

All the investigations are carried out at a single visit to the department. The assessment is then reported to the referring physician (with a copy to the patient’s GP in the case of secondary care referrals).

The individualised report contains a summary of the BMD results and the results of any further investigations, a clinical interpretation and management advice. This will include recommendations about treatment, lifestyle modification, further investigation and follow-up.

On the basis of the fracture risk assessment, approximately 5% of patients are identified as needing further investigation and this is carried out in the Metabolic Bone Clinics.

Common reasons for further investigation would be very severe osteoporosis or deterioration despite treatment.

We accept referrals from medical practitioners in primary or secondary care or other health professionals acting on behalf of a medical practitioner under an approved protocol (for further information please contact the department)

Referral criteria
  • Patient with a history of low trauma fracture
  • Patient on, or commencing, systemic glucocorticoid treatment
  • Osteopenia (or low bone density) reported on x-ray by radiologist
  • Patient with disease or medication known to cause osteoporosis 
  • Fracture probability by FRAX® indicating need for BMD measurement or treatment
  • Follow-up scan to assess change in BMD

Individuals identified as being at increased risk of fracture using the FRAX R risk assessment tool may be referred as described in the guidance on the referral form, which can be found here.


Additional Information

Contact Us

Metabolic Bone Centre
Sorby Wing, Northern General Hospital
Herries Road
S5 7AU

Telephone Appointments
0114 2715340

0114 2714783

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