Optimizing Fracture Prevention in Patients with Osteoporosis.

Purpose: This Maintenance of Certification activity was designed to help address gaps in osteoporosis management, provide practice improvement based on recognized models, and evaluate the impact of the initiative.

Methods: The program comprised 3 stages: stage A, practice self-assessment and chart review; stage B, an intervention to address at least 1 problem; and stage C, additional chart review (new patients). Data from stages A and C were compared to evaluate the impact of the activity.

Role of RANK ligand and denosumab, a targeted RANK ligand inhibitor, in bone health and osteoporosis: a review of preclinical and clinical data.

Background: Postmenopausal osteoporosis results from bone loss and decreased bone strength mediated by an increased rate of bone remodeling secondary to reduced estrogen levels. Remodeling cycles are initiated by osteoclasts, the formation, function, and survival of which depend on RANK ligand (RANKL). RANKL inhibition therefore represents a novel strategy for reducing remodeling and its effects on fracture risk.

Algorithmic approach to the management of the patient with lumbar spinal stenosis.

A 71-year-old generally healthy woman presents for her first visit in 3 years. She ambulates slowly from the waiting room, with a more stooped posture than previously. She reports a 2-year history of slowly worsening buttock and leg pain when she walks any distance.