Osteoporosis

Osteoporosis

Wednesday, February 16, 2011

How Is Osteoporosis Treated and Prevented?

The goal of osteoporosis treatment is the prevention of bone fractures by stopping bone loss and by increasing bone density and strength. Although early detection and timely treatment of osteoporosis can substantially decrease the risk of future fracture, none of the available treatments for osteoporosis are complete cures. In other words, it is difficult to completely rebuild bone that has been weakened by osteoporosis. Therefore, prevention of osteoporosis is as important as treatment. We'll take a look at some of the prevention and treatment options on the following slides.

How Is Osteoporosis Diagnosed?

A routine X-ray can suggest osteoporosis of the bone, which appears much thinner and lighter than normal bones. Unfortunately, by the time X-rays can detect osteoporosis, at least 30% of the bone has already been lost. In addition, X-rays are not accurate indicators of bone density. The appearance of the bone on the X-ray is often affected by variations in the degree of exposure of the X-ray film.
The National Osteoporosis Foundation, the American Medical Association, and other major medical organizations are recommending a dual energy X-ray absorptiometry scan (DEXA or DXA) for diagnosing osteoporosis. The test measures bone density in the hip and the spine, takes only five to 15 minutes to perform, uses very little radiation (less than one-tenth to one-hundredth the amount used on a standard chest X-ray), and is quite precise.

What Factors Determine Bone Strength?

Bone mass (bone density) is the amount of bone present in the skeletal structure. Generally, the higher the bone density, the stronger the bones. Bone density is greatly influenced by genetic factors and can be affected by environmental factors and medications. For example, men have a higher bone density than women. African Americans have a higher bone density than Caucasian or Asian Americans. Normally, bone density accumulates during childhood and reaches a peak by around 25 years of age. Bone density is then maintained for about 10 years. After age 35, both men and women will normally lose 0.3%-0.5% of their bone density per year as part of the aging process.

Menopause, Estrogen, and Osteoporosis

Estrogen is important in maintaining bone density in women. When estrogen levels drop after menopause, bone loss accelerates. During the first five to 10 years after menopause, women can suffer up to 2%-4% loss of bone density per year! This can result in the loss of up to 25%-30% of their bone density during that time period. Accelerated bone loss after menopause is a major cause of osteoporosis in women.

What Are the Symptoms of Osteoporosis?

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture.
The osteoporosis condition can be present without any symptoms for decades. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. Symptoms depend on the location of the fracture. We'll take a look at the most common locations for osteoporotic fractures on the next few slides

Osteoporosis Symptoms: Fractures of the Spine

Fractures of the spine (vertebra) can cause severe "band-like" pain that radiates around from the back to the side of the body. Over the years, repeated spine fractures can cause chronic lower back pain as well as loss of height or curving of the spine, which gives the individual a hunched-back appearance of the upper back, referred to as a "dowager hump."

Osteoporosis Symptoms: Stress Fracture

A fracture that occurs during the course of normal activity is called a minimal trauma fracture or stress fracture. For example, some patients with osteoporosis develop stress fractures of the feet while walking or stepping off a curb.

Osteoporosis Symptoms: Hip Fracture

Hip fractures typically occur as a result of a fall. With osteoporosis, hip fractures can occur as a result of trivial accidents. Hip fractures may also be difficult to heal after surgical repair because of poor bone quality.

Does Osteoporosis Only Affect the Elderly?

Osteoporosis has often been thought to be a condition that frail elderly women develop. However, the damage from osteoporosis begins much earlier in life. Because peak bone density is reached at approximately 25 years of age, it is important to build strong bones by that age, so that the bones will remain strong later in life. Adequate calcium intake and exercise are essential for building strong bones.

Why Is Osteoporosis an Important Public Health Issue?


In the United States, more than 10 million people have osteoporosis and almost 34 million more have low bone density. Approximately 80% of those with osteoporosis are women. Of people older than 50 years of age, one in two women and one in eight men are predicted to have an osteoporosis-related fracture in their lifetime. White and Asian racial groups are at a greater risk. With the aging of America, the number of people with osteoporosis-related fractures will increase substantially. The pain, suffering, and economic costs will be enormous.

Tuesday, February 15, 2011

Osteoporosis

Osteoporosis: Thinning of the bones with reduction in bone mass due to depletion of calcium and bone protein. Osteoporosis predisposes a person to fractures, which are often slow to heal and heal poorly. It is more common in older adults, particularly post-menopausal women; in patients on steroids; and in those who take steroidal drugs. Unchecked osteoporosis can lead to changes in psoture, physical abnormality (particularly the form of hunched back known colloquially as "dowarger's hump"), and decreased mobility.
Osteoporosis can be detected by using tests that measure bone density. Treatment of osteoporosis includes ensuring that the diet contain adequate calcium and other minerals needed to promote new bone growth, and for post-menopausal women, estrogen or combination hormone supplements.