Chief : Aasis Unnanuntana, M.D., MS. Email : uaasis@gmail.com
Attending staffs :
Weerasak Suthipornpalangkul, M.D.
Pojchong Chotiyarnwong, M.D.
Honorary advisors :
Professor Narong Boonyaratvej, M.D.
Professor Saranatra Waikakul, M.D.
Introduction
Metabolic bone disease is an umbrella term referring to abnormalities of bone caused by a broad spectrum of disorders such as osteoporosis (รูปกระดูก). Although the metabolic bone disease service at Siriraj hospital was just established officially in 2011, the department has done tremendous work in this field decades ago led by Prof. Emeritus Narong Boonyaratvej. With a goal to implement a comprehensive patient care, the metabolic bone disease clinic was established in 2012 (รูป clinic). This clinic is the first metabolic bone disease clinic in Thailand. The goals of metabolic bone disease clinic are to advance patient care in osteoporosis, develop an infrastructure for continued clinical research, and improve the education of residents and fellows.
Clinical service
The metabolic bone disease service has continued to focus on the treatment of patients with fragility fractures. Patients at risk of osteoporosis or fragility fracture are referred to our metabolic bone disease clinic for a thorough clinical evaluation. These patients will receive a comprehensive history and physical examination, basic laboratory investigation, and appropriate medication. All patients will be instructed to take appropriate calcium and vitamin D supplements, and if indicated, anti-osteoporosis medication will be prescribed. In addition, an osteoporosis education and fall prevention protocol will be given
Training
The teaching in metabolic bone disease area involves both under-graduated and post-graduated levels. For the under-graduate level, we introduce the basics of metabolic bone diseases to the 5th year medical student. In this topic, we cover the principle of bone remodeling process, pathophysiology and management of osteoporosis. As for the residency training program, the curriculum will be conducted via case based discussion, topic presentation and small group discussion. Some research studies of interest will also be presented and discussed regarding their relevance and their application to the routine clinical practice.
Research interest
We are interested in developing a post-fracture care program. We are creating a care team as a fracture liaison service to take care of patients with fragility fractures. Other areas of interest include the study of appropriate vitamin D supplementation for Thai patients, the effect of anti-osteoporosis drugs on osseointegration after joint replacement or spinal fusion, the use of these agents to facilitate functional outcomes after orthopaedic surgery, and clinical trials of some novel osteoporosis agents. Our future plan is to develop a multidisciplinary care team for osteoporosis patients, which will include physicians from other subspecialties including endocrinologist, nephrologist, radiologist, physiatrist and geriatrician.
