Figure 1:

Integrated approach to the management of bone health and fracture prevention in postmenopausal females and males aged 50 years and older. See Appendix 1, Supplementary Tables 1–6 (available at www.cmaj.ca/lookup/doi/10.1503/cmaj.221647/tab-related-content) for more information on exercise and nutrition, secondary causes of osteoporosis and vertebral fracture assessment. Note: BMD = bone mineral density. ^*Consider lateral spine imaging to identify vertebral fracture(s). Finding of undiagnosed vertebral fracture(s) can guide appropriate choice and duration of therapy (Appendix 1, Supplementary Table 6). †Fractures that occur after the age of 40 years, in the setting of low trauma. Fractures of the hands, feet and craniofacial bones are not considered osteoporotic fractures. ‡Conditions known to cause secondary osteoporosis (Appendix 1, Supplementary able 5); consider referral to specialists with expertise for co-management. §Should be reassessed earlier if patient develops secondary causes (Appendix 1, Supplementary Table 5), new fracture or other risk factor for rapid bone loss.