JAAPA CME Post-Test November 2025

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An Update on Osteoporosis Management and Fracture Prevention Strategies

Every three seconds worldwide, a fracture due to osteoporosis occurs. Yet approximately 80% of individuals who have sustained a fragility fracture are not identified as having osteoporosis or treated for the condition. Many misconceptions and barriers plague care for this “silent” condition, contributing to a health care gap with catastrophic consequences. Importantly, clear guidance on screening, prevention, and treatment is available, paving the way for clinicians who are willing to “own the bone” and narrow the gap. Most recently, the U.S. Preventive Services Task Force (USPSTF) published updated guidance for osteoporosis screening in early 2025. This guidance largely supports previous recommendations, strengthening the firm foundations clinicians use to address this critical need.

Learning Objectives

At the conclusion of this activity, participants should be able to:
  • Summarize osteoporosis screening guidelines and recommendations
  • Detail osteopenia and osteoporosis diagnostic criteria, including the roles of bone mineral density, fracture risk assessment, and fracture history
  • Describe key characteristics that identify individuals at very high risk of fracture
  • Develop a comprehensive individualized osteoporosis treatment plan that includes lifestyle and nutritional interventions, fall precautions, and pharmacologic management

Diagnosis and Management of Axial Spondyloarthritis

Low back pain is among the most common conditions treated by physician associates in family medicine, internal medicine, and emergency medicine clinics. Inflammatory low back pain is the most frequent manifestation of axial spondyloarthritis (axSpA). AxSpA has a prevalence of 1.0% to 1.4% in the United States. The diagnosis of axSpA includes both clinical and radiographic components. With the advancement of biologic pharmacologic agents, the American College of Rheumatology, Spondylitis Association of America, and Spondyloarthritis Treatment Network have provided updated recommendations for the pharmacologic and nonpharmacologic management of axSpA. The recognition of axSpA and comorbid peripheral spondyloarthropathies is important, as the management of axSpA differs from routine musculoskeletal back pain. Treatment guidelines focus on symptom management, functionality, and disease progression.
 

Learning Objectives

At the conclusion of this activity, participants should be able to:
  • Describe the prevalence of axSpA in the general population
  • Identify the primary autoimmune mechanisms involved in axSpA development including immune cell interactions, cytokine-induced inflammation, and genetic predisposition
  • Recognize common comorbidities of axSpA including peripheral arthropathies
  • Describe the pharmacologic and nonpharmacologic treatment options for patients with axSpA
 

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