The metabolic bone unit provides expert advice, investigation and treatment for patients with osteoporosis (fragile bones) and other metabolic bone diseases. This includes Paget’s Disease and Osteogenesis Imperfecta, as well as rarer bone diseases.
We provides metabolic bone advice to specialties across the trust, as well as answering primary care queries regarding bone health. The unit is based in the musculoskeletal outpatient department at Freeman Hospital and holds a range of specialist clinics.
The unit, led by consultants, is also supported by osteoporosis specialist nurses, a pharmacist, additional doctors and a physiotherapist experienced in metabolic bone disease.
Rapid diagnosis
When appropriate, we will offer you a dual energy x-ray absorptiometry (DXA) to diagnose osteoporosis and assess future fracture risk. DXA scan results, together with information on clinical risk factors and other relevant medical issues, can help to identify whether or not patients would benefit from preventative treatment.
The metabolic bone unit sees referrals from primary care as well as a wide range of specialists within the trust. A fracture liaison service (FLS) and orthogeriatrics’ team also facilitates care of patients admitted to hospital with a fracture (broken bone). You may also be seen in the metabolic bone clinic for ongoing management decisions. The aim is to reduce the risk of fractures within this patient population.
Treatment
You can take some bone treatments medication in the community. Reviews and investigations (such as blood tests or scans) will take place at the hospital when necessary.
Some treatments (such as zoledronate infusions) you will have in hospital via a drip. You will receive this on the rheumatology day case unit.
Nurses and nurse practitioners primarily staffed the day case unit. Nurses and nurse practitioners have experience in administering bone-sparing treatments such as zoledronate infusions.
If you are starting denosumab treatment (an injection underneath the skin) you should also have your first injection at the day unit. A GP surgery can sometimes give future injections. However, if there are complications, such as reduced kidney function, you will need to attend the day case unit more frequently for blood tests and injections.
Bone-sparing treatment courses are usually for several years. Therefore, patients with metabolic bone disease do not need to be seen as frequently as other rheumatology patients. They should have a clinic review following completion of a treatment course, or every 3 years if on lifelong treatment – or more frequently if new issues arise.
Research and excellence
We take part in a variety of research and educational initiatives. We can offer you the chance to try potential new therapies for your condition, which often allows you to be the first to benefit from innovative new treatments. The metabolic bone team participates in several local and regional multidisciplinary team meetings to provide the best care for patients.
The Freeman Hospital is a Paget’s Disease Centre of Excellence. There is also a combined clinic with the clinical genetics service for patients with rarer bone conditions.
