The National Osteoporosis Society website is not one I'm that keen on, but it does have a useful A-Z of resources aimed at medical professionals.
What I would really like to see is a concise, all-embracing, up-to-date overview of osteoporosis, but here the information is presented in about 50 separate documents, and you have to trawl through this to get what you want.
That is not to say some of them are not useful, dealing as they do with specific problems such as the value of ultrasound or the situation regarding Depo-Provera.
There are some useful patient leaflets, too - but it's just not easy enough to sift through it all.
Why go there: Addresses specific topics.
Downside: Not easy to use.
Information from: National Osteoporosis Society.
As the authors point out, osteoporosis is no longer a disease of fractures but a disease of fracture risks. Like blood lipids and blood pressure, bone mineral density is now viewed as a predictor of possible problems.
They go on to explain how GPs can identify patients at risk and those who might benefit from intervention.
One interesting aspect of these pages is that separating risk factors which operate through an effect on bone mineral density (BMD) from those that have no direct effect on BMD is discussed in some detail.
Why go there: Covers all the main points.
Downside: Published in 1998, so could do with updating.
Information from: Postgraduate Medicine Online.
DIRECT ACCESS TO DXA
According to this journal article, GPs should have direct access to DXA scanning, although the reasons are something of a two-edged sword.
It was found that GPs often did not assess risk factors adequately, although database searches might identify more potential at-risk patients. But if a DXA scan was performed and found to be abnormal, GPs were three times more likely to start potent osteoporosis treatment. Sounds like an opportunity for a practice-based commissioning service.
Why go there: Shows DXA scans are not just for secondary care.
Downside: Not a quick read.
Information from: Annals of Rheumatic Diseases.
DON'T GO HERE
This is a website that advertises genetic testing for 'bone health' including osteoporosis.
The testing involves the analysis of four genes 'that may play an important role in determining how your body manages overall bone health; and, in relation to your genes, assesses seven key diet and lifestyle action areas'.
The authors of these pages also say that statements made on the website are based on their 'best understanding', whatever that means. And if you look hard enough you'll find the small print that says: 'The Cellf Genetic Assessment is not a genetic test for disease or pre-disposition to disease.' So what, I have to ask, is the point in buying one of these kits that will set you back around £100?
Why not go there: In my opinion, a waste of money.
Upside: I give up, I couldn't find one.
Information from: Scionia cellf.
- Dr Barnard is a former GP in Fareham, Hampshire
WEBSITE OF THE WEEK
I'm a big fan of the Scottish Intercollegiate Guidelines Network (SIGN), especially the 'Quick Reference Guides'.
This website does an excellent job of condensing a difficult and complex topic into two sides of a downloadable PDF that makes an easy-to-follow A4 leaflet.
On one side is a summary of risk factors, diagnosis and pharmacological and non-pharmacological management. On the reverse is a flow chart that suggests the need for DXA, its interpretation according to the nature of the presentation, and finally, a list of the various treatment options.
Why go there: A must for bookmarking.
Information from: SIGN.