Fracture Liaison Service
What is a Fracture Liaison Service?
Fracture Liaison Services (FLS) systematically identify people aged 50 and older who have had a ‘fragility fracture’, with the aim of reducing their risk of further fractures.
Osteoporosis is the fragile bone disease associated with an increased risk of fragility (low impact) fractures, the consequences of which can be significant.
Fragility fractures are:
- Common: One in two women and one in five men break a bone after the age of 50
- Costly to the NHS: The hospital costs of hip fractures alone are estimated at £1.1 billion.
- Life-changing to the individual: The impact of fractures may lead to loss of mobility and independence, social isolation and depression.
Many fragility fractures could be prevented by timely interventions to reduce fracture risk. A FLS systematically identifies, treats and refers to appropriate services all eligible patients aged over 50 within a local population who have suffered a fragility fracture, with the aim of reducing their risk of subsequent fractures.
A fracture, crack or broken bone especially caused by minimal or low trauma (including spinal / vertebral fractures) over the age of 50 years in both men and women MAY be a first sign of low bone density. A simple DXA scan will indicate if this is the case and along with assessment of your individual risk of fracture.
As around 50% of people who experience a hip fracture have broken a bone in the past, FLS represents an ideal opportunity for intervention in the journey to avert that future hip fracture.
I am over the age of 50 years and I have had a fracture. Why do I need a DXA scan?
If you are aged 50 and over you may have experienced a low trauma cracked or broken bone, which is also known as a fracture. This fracture occurs with minimal trauma such as from a standing height or less rather than excessive trauma such as a traffic collision or sports injury.
This MAY be a first sign of bone thinning. If this type of fracture occurs we will invite you for a DXA scan as part of our FLS but your GP can also refer you too.
FLS Leaflets
What is a DXA scan? Is it the same as an Isotope Bone Scan?
DXA stands for Dual Energy X ray Absorptiometry. It is NOT the same as an Isotope Bone Scan.
What is osteoporosis? Should I be worried?
Osteoporosis occurs when the structure of the bone becomes thin and so more fragile. Osteoporosis is a common condition with 1 in 2 women and 1 in 5 men over 50 having a fracture.
Osteoporosis isn’t a painful condition as we don’t feel the loss of bone. However, the broken bones we get from osteoporosis can cause pain and sometimes other problems (including difficulty with mobility and doing daily activities).
Broken bones will usually heal normally but a broken hip or spinal fracture can have a major impact on your independence.
What is a low trauma or fragility fracture?
This is when bones break, following mild trauma such as a bump or fall.
Fractures that occur as a result of trauma are not typically due to osteoporosis. For example, a road traffic collision or a fall from height e.g. a ladder or cycle.
What bones are commonly broken if you have osteoporosis?
Wrist, hip, spine and pelvic fractures are most commonly related to osteoporosis. However, any bone that breaks easily in men and women aged over 50 is likely to be related in some way to bone fragility.
Skull, hand, fingers and toes, foot or rib fractures are usually caused by trauma and therefore not considered as part of our FLS service
Might I be asked to start treatment without a DXA bone scan?
In those aged 75 years and over who have a low trauma fracture, we sometimes recommend that treatment be commenced for a 5 year period without a DXA Bone scan. This is because these individuals are at highest risk of further fracture.
Do I need a DXA scan if I’m already taking a bone treatment?
We would repeat your DXA bone scan sooner than previously recommended but not until 2 years have passed since your last DXA scan.
I don’t think I had a low trauma fracture. What should I do?
If the broken bone was as a result of some trauma such as a fall from a step ladder or a bicycle or a road traffic collision a DXA scan isn’t required.
Please let us know that you don’t need a scan so we can offer your appointment to someone else.
To cancel your appointment, please contact:
Email: gram.osteoporosis@nhs.scot
Tel: 01224 559970 or 559971
Please quote your name, date of birth or CHI number (this is on your invitation letter).
Where are the scanners situated?
The DXA scanners are situated at the Grampian Osteoporosis Service, Ground Floor, Ashgrove House, Foresterhill, Aberdeen, AB25 2ZA and a scanner is also in the Out Patient department of Dr Gray’s Hosital Elgin. We have a mobile DXA scanner which visits Aboyne, Orkney and Shetland.
How can you measure bone density?
The most common way to measure your bone density is with a DXA BONE SCAN. This is the most accurate and reliable way of assessing the strength of your bones and their future risk of fractures (broken bones).
Is a DXA scan safe?
Yes. It involves a relatively small radiation dose which is similar to natural background radiation or less than one tenth the dosage of radiation that you would get from a chest X ray.
Which bones are scanned?
DXA machines usually scan the lower spine and both hips. This helps us determine your individual risk of fracture and a possible diagnosis of osteoporosis. We may scan your spine with you lying on your side to check if you have a spinal fracture. Occasionally we scan the forearm or do a whole body assessment.
We look forward to welcoming you to the DXA scanning service.
Further Information and Patient Resources
The Royal Osteoporosis Society
The UK’s only national charity dedicated to bone health and osteoporosis.
Website, downloadable information and Freephone Helpline run by specialist nurses:
Tel: 0800 80 0035 or E-mail: nurses@theros.org.uk
Published: 24/08/2022 15:08