In this fourth National Osteoporosis Foundation of South Africa (NOFSA) 2024 Masterclass series, Professor Conradie considers the need for screening of the patient who presents with skeletal fragility and without a known or clinically overt secondary cause of osteoporosis. She provides guidance and a practical framework for appropriate use of available screening modalities in patients younger than or older than 40 years.

Modifiable and non-modifiable risk factors for the development of osteoporosis are an important aspect of screening and include a broad spectrum of systemic disease and pharmacotherapy with potential adverse skeletal effects.

Quantification of the fracture risk of patients with known secondary causes of osteoporosis is similar as for patients with primary osteoporosis. Validated South African reference data is available on the FRAX assessment tool that is especially useful when access to DXA is not available; further guidance is provided on adjusting the FRAX score to accommodate risk factors that are not included in the FRAX calculation, thereby enabling a more accurate assessment of 10-year risk of major osteoporotic fracture.

In closing, Professor Conradie provides an overview of which indications may warrant consideration of bone-specific therapy in secondary osteoporosis, the general principles of management of osteoporosis for all patients, supportive measures, and how and when to use available bone-specific pharmacotherapies.

You will learn about:

• How to screen for secondary causes of osteoporosis in the patient with skeletal fragility
• An awareness of the broad spectrum of secondary causes of osteoporosis
• How to assess fracture risk in the presence of a secondary cause of osteoporosis
• Principles of integrated management and an approach to pharmacotherapy for the treatment of secondary osteoporosis.

Professor Magda Conradie
Associate Professor of Medicine, Consultant Endocrinologist, Tygerberg Hospital, University of Stellenbosch

Prof Magda Conradie is a highly accomplished Consultant Endocrinologist and Associate Professor at Tygerberg Hospital and Stellenbosch University in South Africa. With a PhD in Internal Medicine and extensive expertise in metabolic bone diseases and endocrinology, she has contributed significantly to the field with over 70 peer-reviewed publications. Her research spans osteoporosis, postmenopausal breast cancer, and bone health, garnering over 345 citations and a research interest score of 218.3. Prof Conradie is also a distinguished academic, supervising postgraduate research and delivering presentations nationally and internationally.