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

Why is Bone Health important?

Strong bones support our bodies and allow us to move. Bones protect our organs from injury and store vital minerals we need to live. Weak bones can break and cause pain leading to difficulty walking without assistance. Bones begin to weaken early in life without the right diet and exercise, and many people have weak bones without knowing it.

The consequences of weak bones include osteoporosis and fragility fractures. Over time, bones lose important minerals like calcium causing them to become brittle and fragile. Brittle bones can break easily, which can be life-altering and even deadly. Those breaks are known as fragility fractures and can occur with little or no trauma, and stem from osteoporosis. 

Initial Visit

During your first visit, we’ll review your medical and fracture history, evaluate your risks for osteoporosis 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. 


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, Abaloparatide and Romoosozumab 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.