Background: National osteoporosis guideline group recommend routine measurement of thyroid function tests. However it is well recognised that abnormal thyroid function tests done during acute hospital stays is not always suggestive of thyroid dysfunction and that they need to be repeated to determine the need for further management.
Aim: To identify and assess the follow up of thyroid function tests (TFTs) done between June 2009 and Feb 2010 in the orthopaedic ward of our hospital as part of osteoporosis screening.
Method: TFTs requested from the orthopaedic ward at our hospital between June 2009 and Feb 2010 were identified via the pathology lab database. Abnormal TFTs were followed up on the hospital database to determine if they had been repeated, investigated further or referred to the endocrine service.
Results: Three hundred and three patients (65 males, 258 females) had TFTs requested from the orthopaedic ward during the specified period.
59/303 patients had initially abnormal TFTs. 29 patients had isolated suppressed TSH mean 0.28 (range 0.040.38) and 26 patients had isolated raised TSH mean 8.4 (range 5.237). 4 patients had suppressed TSH with elevated free thyroid hormones (free T4 range 13.932).
20/59 patients had repeat TFTs while 39 patients had no recorded repeat tests on the hospital database. The median interval of repeat TFTs was 6 weeks (range 3 days to 12 weeks). None of the patients with abnormal TFTs had thyroid antibodies done and only one was referred to endocrine services.
Conclusion: There is a wide variability in the follow up of thyroid function tests done for osteoporosis screening with majority of patients not having follow up investigations.
There needs to be more awareness among the health professionals about the appropriate follow up of thyroid function tests done in acute hospital setting.