osteoporosis

About Osteoporosis

Fractures, associated with minimal trauma, are a major health problem in the older population, particularly for women.

The lifetime risk of any fracture of the hip, spine or forearm is estimated at almost 40% for women and 13% of men from age 50 years onwards. The incidence is rising due to the increased expectation of life in recent decades.

Loss of bone density due to osteoporosis is the most common generalised skeletal disease, and the major cause of minimal trauma fracture. Less common causes are congenital problems, lack of Vitamin D due to diet and lack of sunlight, and some long term drug treatments.

Bone mass rises to a peak in the early 20's, but declines from the 50's, most rapidly in women after the menopause. It is accepted that a diet high in calcium-rich foods (eg dairy products) and exercise can help build calcium stores when young.

There are many methods for measuring bone mineral density (BMD):

DEXA (dual energy x-ray absorptiometry)
QCT (quantitative computed tomography
radioactive iodine (single or dual photon absorptiometry)
ultrasound (broadband or speed of sound methods)

The radioactive iodine examinations have largely been replaced by x-ray due to improved precision and cost effectiveness. The radiation dose for QCT is 50 to 100 times greater than DEXA, and QCT is more expensive. There are many variables with measurements obtained with ultrasound techniques, which exclude ultrasound as a routine diagnostic tool for clinical applications.

DEXA is the most reliable, accurate and repeatable measure of BMD. The examination is fast, comfortable and can be used to evaluate different sites.

Both lumbar spine and femoral neck measurements are routinely obtained to provide:
1) fracture risk estimate
2) assessment of progression of osteoporosis OR response to treatment.

Various treatments are available for osteoporosis. See your doctor for advice.