If you have experienced a fracture with little or no trauma, you’ve had what is called a fragility fracture, and it stems from osteoporosis. University of Missouri Health Care's Fracture Liaison Service is here to help you avoid future fractures by building and maintaining bone health. 

older couple enjoying exercise

Initial Visit

During your first visit, we’ll review your recent fracture and medical history, evaluate your risks for another fracture and discuss treatment options. 

Questions we may ask:

  • Have you had a bone density test before? If so, please let us know when it was done and bring a copy for our records.
  • Have you ever been told you have bone loss, osteoporosis or osteopenia? 
  • Do you take calcium or vitamin D supplements?
  • Have you had any other broken bones after age 49?

Understanding Bone Health

To understand your current bone health, we’ll use a combination of the following methods:

  • Medical History: We’ll ask you questions relating to any personal or family history of fractures and other risk factors for osteoporosis. It’s important to let your provider know which medications you’ve been taking during the last 10 years due to certain medication risks of low bone mass and fractures. 
  • Physical Examination: Your provider will give you a limited physical exam with emphasis on the spine. Many fragility fractures go unnoticed by patients. Loss of height can be a good indicator of vertebral fragility fractures. 
  • Lab Tests: Some lab tests are specific to bone health. We’ll check your medical records to see if any of these have been performed in the last six months, and if not, we’ll perform them. 
  • X-rays: An X-ray can help us determine if you’ve had any fragility fractures of the spine.
  • Bone Density Scan: If any tests indicate probable loss of bone density, and you haven’t had a bone density scan in the last year, we’ll make arrangements for you to have one. This will help us confirm a diagnosis of osteoporosis and document the severity of bone loss. 

Follow-Up Visits

You’ll be scheduled for a follow-up appointment one to three months after your initial visit. At that time, we’ll evaluate your treatment progress and plan any future steps for your care. 

Medication

Your treatment plan might include medications for osteoporosis, and those fall into one of two categories: antiresorptive medications to slow bone loss or anabolic drugs to increase the rate of bone formation. 

Antiresorptive Medications: Bisphosphonates, calcitonin, denosumab, estrogen and estrogen agonists/antagonists are antiresorptive medicines. Because your bones are continually losing and replacing tissue, these medications work to slow down the pace of tissue being lost while your body continues to generate new bone tissue. 

Anabolic Drugs: Currently, Teriparatide and Abaloparatide are the only osteoporosis medications approved by the FDA to rebuild bone. With the ability to increase bone mass and strength, the goal of anabolic drugs is to build healthier bones while reducing the risk of fractures. 

Cost of Care

Because of the risk of future fractures, fracture liaison services are considered a medical necessity by most insurance providers. Each service should fall under your coverage, but it’s best to double check with your provider before being treated. Deductibles, co-insurance, copays and other balances may be due at the time of your appointment.