OBJECTIVE: To assess compliance with current Canadian osteoporosis guidelines and whether scores on a fracture risk assessment tool in patients with rheumatoid arthritis correlate with their likelihood of receiving anti-osteoporosis therapy and bone mineral density screening. METHODS: A series of rheumatoid arthritis outpatients’ cases were reviewed, and data were collected on patients’ bone mineral density test results and calcium, vitamin D, and osteoporosis treatment. A ratio (OR) was calculated to determine whether a higher fracture risk assessment score would increase the likelihood of osteoporosis treatment or performing a bone density screening. RESULTS: Using the fracture risk assessment tool to calculate the 10-year risk of osteoporotic fracture at major sites, 92 patients (12.5%) were at high risk, 216 patients (29.3%) were at intermediate risk and 429 (58.2%) were at low risk. Compared with patients in the low-risk group, patients in the high-risk group were more likely to receive anti-osteoporosis drugs (OR 16.31, 95% CI 9.45C28.13, P < 0.001), calcium (OR 3.89, 95% CI 2.43C6.25, P < 0.001) and vitamin D (OR 3.46, 95% CI 2.12C5.64, P < 0.001) treatment and bone mineral density screening (OR 10.22, 95% CI 5.50C18.96, P < 0.001). nearly half (46.8%) of the 124 patients currently receiving prednisone therapy were prescribed diphosphonates. CONCLUSION: Overall, compliance with current osteoporosis treatment guidelines in the management of patients with rheumatoid arthritis was low, but those at higher risk were more likely to undergo bone mineral density screening and receive anti-osteoporosis therapy, with clear dose differences from low to high according to 10-year fracture risk. For patients with rheumatoid arthritis, regardless of disease duration, those with high risk factors such as age >50, menopause, previous history of fragility fracture or family history of fracture, or taking hormones must be screened for osteoporosis, with bone density screening feasible if available, or FRAX score if not available, and antiosteoporosis therapy should be administered as early as possible for patients at high to moderate risk to avoid fragility fracture The occurrence of fragility fracture. At present, there is still not enough emphasis on this aspect, both nationally and internationally. The importance of this aspect has been noted in the routine clinical work of our department, but there is still a need to strengthen patient education and improve patient compliance. The general public should also continue to improve their awareness of the disease and actively prevent and treat osteoporosis. In particular, many advertised drugs that can “cure” rheumatoid rheumatism contain large amounts of hormones, which are an important risk for the development of osteoporosis, so do not believe them blindly.