Performance of Osteoporosis Self-assessment Tool for Asian (OSTA) for Primary Osteoporosis in Post-menopausal Malay Women

The Osteoporosis Self-Assessment Tool for Asians (OSTA) score has been developed to identify women at risk of osteoporosis. It can be used as a screening tool for patients at risk who would benefit from bone mineral density measurement and treatment. It was developed based on data from eight countries including Malaysia. However, most subjects were of Chinese (59%). This study evaluated the performance of OSTA among 152 post-menopausal Malay women. OSTA score calculation and DEXA scan were performed. Our results showed that the OSTA score is a good predictor of patients at risk of osteoporosis based on BMD measurements at the proximal femur. Instrument sensitivity was 87.5%, specificity was 95.8%, positive predictive value (PPV) was 0.538, negative predictive value (NPV) was 0.993, and the area under the receiver operating characteristic curve (ROC) was 0.895. We conclude that use of the OSTA score in postmenopausal Malay women is effective and has adequate sensitivity and specificity.

Non-Operative Treatment Versus Steroid Injections in the Management of Unicameral Bone Cysts

The cases of nine patients with unicameral bone cysts were reviewed from two orthopaedic centres. In one hospital, five patients received serial steroid injections, and at the other hospital four patients were treated conservatively following fractures. In the steroid injection group, three cases were in the proximal femur and two in the proximal humerus. The five steroid injection patients showed radiological evidence of cyst healing within six months of treatment. Subsequently four of the patients showed a satisfactory radiological outcome after a year and complete resolution after 2 years. In the conservative group, all four cases were in the proximal humerus. Persistent cystic lesions were observed in all four patients and two was complicated by another fracture within six months.