The increasing difficulty in the diagnosis of these pathology lies on its clinical suspect, which can be clear when having cardiovascular risk factors. Its diagnosis, on a rare scenario, needs leucocytosis and LDH rising as suspicious indicators. Computed tomography, MRI, radionuclids and arteriography may confirm diagnosis. Treatment is based on thrombolytic therapy, anticoagulants and ontiagregants.

BackgroundSecondary prevention of osteoporotic fracture is more efficient with the Fracture Liaison Service (FLS) model.ObjectivesTo describe the characteristics of male patients attended in a FLSMethodsProspective observational study. The program consists of: 1) recruitment from the emergency records, hip fracture admitted or referral to outpatient rheumatology; 3) baseline visit: questionnaire including demographCI variables, FRAX and previous treatments; 4) DXA; 5) patient education; 6) report of results to the patient and the PC doctor, with specifCI management recommendations; complex patients are referred to rheumatology; and 7) follow-up through telephone survey plus prescription check in electronCI records. The characteristCIs of male patients are described and compared with women.Results2,135 patients have been included, 382 male (18%). The recruitment was in 300 cases (78%) from the emergency list, in 55 cases (14%) admission for hip fracture and in 25 cases (6%) from outpatient clinCI. The characteristCIs of the patients are shown in the table.The average age was similar in men and women. Hip fracture was more frequent in men (34% vs. 25%, OR 1.63 CI 95% 1.50-1.75) as opposed to forearm fracture (18% vs. 33%, OR 0.46 CI 95% 0.32-0.60). Male had previous DXA (6% vs 25%, OR 0.22 CI 95% 0.00-0.43) and previous treatment with bisphosphonate (4% vs 19%, OR 0.17 CI 95% 0, 0-0.44) less frequently.Of the variables included in the FRAX, in men was less frequent the previous fracture (13% vs 24%, OR 0.48 CI 95% 0.32-0.64), the hip fracture of the parents (9% vs. 13%; OR 0.66 CI 95% 0.47-0.85) and the use of corticoids (6% vs 10%, OR 0.61 CI 95% 0.39-0.84). However, active smoking was more frequent in men (21% vs 14%, OR 1.67 CI 95% 1.53-1.81) as well as consumption >2 daily units of alcohol (18% vs 5%; OR 3.96 CI 95% 3.78-4.13).The percentage of osteoporosis was lower in men compared to women (30% vs 46%, OR 0.49 CI 95% 0.30-0.68) as well as the percentage of patients with >1 fall in the last year (29% vs 45%, OR 0.51 CI 95% 0.30-0.71).In addition, after the visit to the FLS, a bisphosphonate was indicated less frequently to men than to women (68% vs. 77%, OR 0.64 CI 95% 0.51-0.76) and were referred less frequently to PC (64% vs. 76%; OR 0.55 95% CI 0.41-0.70). Finally, persistence at 12 months was lower in men than in women (53% vs. 68%, OR 0.53 CI 95% 0.30-0.76).ConclusionCompared with women, men seen in an FLS present hip fracture more frequently and a forearm fracture less frequently. Men also have a lower frequency of personal and family history of fracture and a greater frequency of smoking and alcohol intake. The percentage of patients who are candidates for treatment and persistence is lower than in women. These data should be taken into account in the identification and treatment of fragility fracture in men.AcknowledgementFabiola Santana and Carmen AlonsoDisclosure of InterestsAntonio Naranjo Grant/research support from: Amgen, Consultant for: UCB, Speakers bureau: Amgen, UCB, Soledad Ojeda Grant/resear...

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Summary The identification of vertebral fracture is a key point in an FLS. We have analyzed the characteristics of 570 patients according to the route of identification (referral by other doctors, emergency registry or through VFA), concluding that promoting referral by other doctors with a training campaign is effective. Purpose Vertebral fractures (VF) are associated with increased risk of further VFs. Our objective was to analyze the characteristics of patients with VF seen in a Fracture Liaison Service (FLS). Methods An observational study was carried out on patients with VF referred to the outpatient metabolic clinic (OMC) after a training campaign, identified in the emergency registry, and captured by VF assessment with bone densitometry (DXA-VFA) in patients with non-VFs. Patients with traumatic VF or VF > 1 year, infiltrative or neoplastic disease were excluded. The number and severity of VFs (Genant) were analyzed. Treatment initiation in the first 6 months after baseline visit was reviewed. Results Overall, 570 patients were included, mean age 73. The most common route for identifying VF was through referral to OMC (303 cases), followed by the emergency registry (198) and DXA-VFA (69). Osteoporosis by DXA was found in 312 (58%) patients and 259 (45%) had ≥ 2 VFs. The rate of grade 3 VFs was highest among patients on the emergency registry. Those identified through OMC had a higher number of VFs, a higher rate of osteoporosis, more risk factors and greater treatment initiation. Patients with VFs detected by DXA-VFA were mostly women with a single VF and had a lower rate of osteoporosis by DXA. Conclusions We present the distribution of VFs by the route of identification in an FLS. Promoting referral by other doctors with a training campaign may help in the quality improvement of the FLS-based model of care.