ROLE OF GP IN OSTEOPOROSIS MANAGEMENT

fractures will affect one-third of women andone-fifth of men 50 years old and older worldwide.1 Toprevent the inevitable rise in hip fracture occurrences,early patient identification is of paramount importance.Patients with timely osteoporosis diagnosis andappropriate management can remain fracture free.Fracture Liaison Services (FLSs) arecare-coordinator-based secondary fracture preventionprogrammes that systematically identify fragilityfracture patients, then assess, investigate and treatthem for underlying osteoporosis as appropriate.2 Theyare promoted by the International OsteoporosisFoundation (IOF) as a cost-effective strategy forreducing the osteoporosis care gap, the refracture rate,and mortality.3,4 Identifying patients with high fracturerisk using the WHO fracture risk assessment tool(FRAX), and discussing the treatment thresholds basedon patient’s ideas, concerns, expectations and caregoals, using a shared decision-making approach, is apatient-centric and cost-effective way to manageosteoporosis and prevent fractures.

Approach To Symmetrical Polyarthritis with Focus on Rheumatoid Arthritis

Symmetrical polyarthritis is not uncommon as a presenting clinical problem in the primary care setting. The ability to differentiate inflammatory from non-inflammatory, articular from peri-articular joint pain will help the Family Physician (FP) to further narrow the diagnosis of joint pain, and provide early referral and effective treatment when necessary. Integrating clinical reasoning with the concept of likelihood ratios in the process of diagnosis, FPs can also easily differentiate the various diagnoses of symmetrical polyarthritis, including rheumatoid arthritis (RA). There is also increasing evidence that shared care of patients with rheumatoid arthritis can be done successfully and safely between FPs and rheumatologists.