NORTH EAST ESSEX PCT OSTEOPOROSIS SERVICE

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Referral Criteria

                    If one major or two minor criteria are fulfilled your patient qualifies for this service

             Major Criteria                                                                                                        NO        YES

1.                  Low trauma fracture

 

 

2.                  Lost 3” or more in height ( compared with peak adult height)

 

 

3.                  Taking Prednisolone >7.5mgs for >6 months

 

 

4.                  *Osteopenia on Xray                 *Please provide copy of X Ray Report

 

 

5.                  *Vertebral deformity on Xray  *Please provide copy of X Ray Report

 

 

6.                  Avoids dairy produce

 

 

7.                  Body mass index <19kgs/m2

 

 

            Minor Criteria                                                                                    NO        YES

1.                  Sedentary (<4 hours on feet per day & potters around the house)

 

 

2.                  Early menopause <45 years

 

 

3.                  Follow-up scan has been recommended

 

 

4.                  Considering stopping bisphosphonates

 

 

5.                  Prolonged amenorrhoea

 

 

6.                  History of maternal hip fracture

 

 

 

If there are any reasons other than above that you feel warrant a scan please give details.

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Age is a major risk factor for Osteoporosis. If your patient is >80 years he / she can be presumed to be osteoporotic and will benefit (at least)  from calcium and vitamin D (if renal function is adequate and is not hypercalcaemic). Patients who fall are at risk of fracture even if there bones are normal. For recurrent fallers you may wish to  consider a home O.T. assessment & / or recommend fall prevention measures.

 

Return completed form to : PCT Osteoporosis Service, P.O. Box 7035, Colchester CO3 4YB.

Or FAX to 07092 180962.                                     Queries should also be faxed to this number.