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Overview

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We would like to welcome you to our center's bone health section. Our providers are experts in bone health, striving for the most comprehensive evaluations and treatment for osteoporosis and other conditions that cause low bone mass with a tendency to fracture. Although we often see patients with complicated bone problems, we welcome anyone who has a concern about their bone health. If you have experienced a fracture, you can consider our center as a medical fracture clinic where we will try to develop a non-surgical strategy to help prevent further fractures.

What makes our center unique?

We are one of the few Osteoporosis specialty practices in the area to offer comprehensive bone care and specialized services. Patients or their referring physicians can choose any number of these services to help evaluate and treat osteoporosis or low bone mass. Alternatively, patients or referring physicians can request a comprehensive bone health evaluation. Our evaluations are extremely detailed and include:

  • Detailed history and physical exam, focusing on elements that concern a patient's bone health: Although a DXA scan is an important screening tool to evaluate a patient's bone density, the history and physical often provides our experts with the crucial information that determines whether a patient is at a significant risk for future fracture and whether treatment may be indicated.
  • Laboratory/blood work: Although a great majority of women develop bone loss due to the lack of estrogen, there are a number of underlying conditions that can make an individual susceptible to low bone mass and fracture. In order to properly exclude these conditions, our experts order a number of detailed blood and urine tests.
  • DXA (Dual Energy Absorptiometry) Bone Density evaluations: We pride ourselves on quality bone density evaluations. All of our providers have been trained and/or certified by the International Society of Clinical Densitometry.
  • Comprehensive Treatment Program: our comprehensive treatment program goes far beyond merely recommending a medication. We give dietary advice, recommend physical exercise strategies, provide direction for proper physical activity, and work closely with Physical and Occupational Therapy services to help you prevent future fractures.

Osteoporosis - An Overview

Definition

Simply put, Osteoporosis (which literally means "porous bone") is a disease in which bones become fragile and are more likely to break. In more detail, Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. With this definition, bone strength reflects the integration of two important characteristics of bone: bone quality and bone density. Bone density is expressed as grams of mineral per cm2 and is determined by peak bone mass and amount of bone loss. Bone quality refers to architecture, turnover, damage accumulation (e.g., microfractures) and mineralization. Osteoporosis should not be confused with conditions that have similar sounding names, like osteoarthritis, osteonecrosis or osteomalacia.

History

It is interesting to note that the disease of Osteoporosis is indeed a disease of antiquity.the skeletons of Egyptian mummies from 4,000 years ago show evidence of spinal osteoporosis. The term "osteoporosis" was coined in 1820 by Dr. Jean Lobstein, a French pathologist who noticed that some patients' bones had larger than normal holes.

Burden of Disease & Scope of Problem

  • Osteoporosis affects an estimated 75 million people in the USA, Europe, and Japan
  • Osteoporosis affects both men and women of all races and ethnicities
  • More than 10 million people in the U.S. have osteoporosis (8 million women and 2 million men) and over 33 million individuals have low bone density measured at the hip
  • 30% of postmenopausal women have osteoporosis
  • About 50% of Caucasian women (that is one out of every two women) will experience an osteoporotic fracture at some point in their life
  • About one out of every five men will experience an osteoporotic fracture at some point in their life
  • There are about 2 million osteoporotic fractures yearly in the United States.
  • By 2025, experts predict that the number of fractures will rise to more than 3 million
  • By 2050, the worldwide incidence of hip fracture in men is projected to increase by 310%; the incidence is projected to increase 240% in women

Symptoms

Osteoporosis is often referred to as the "silent epidemic." This is because in the vast majority of patients, since bone loss is gradual and painless, there are usually no symptoms that would indicate that a person is developing osteoporosis.

Unfortunately and all too often, the first sign of osteoporosis is heralded by a new fracture. Although any bone can be involved, the bones most susceptible to an osteoporotic fracture include the bones of the spine, hip, and wrist. Vertebral fractures are also a common occurrence in osteoporosis. Although these can cause severe pain, about a quarter of patients have no symptoms whatsoever. In these patients, the fractures can lead to a loss of height or a stooped posture, medically referred to as "spinal kyphosis."

Another consequence of osteoporosis is the development of an abnormal rounding of the spine in the upper back just below the neck area, often referred to as a "dowager's hump." A hip fracture is a catastrophic event for a patient and has a profound impact on the quality of life. A significant portion of patients who sustain a hip fracture lose the ability to live independently; a smaller, but important percentage of individuals die from complications surrounding the fracture.

Osteoporosis Progression Chart

Diagnosis

The early diagnosis of osteoporosis is important so that the consequence of low bone mass, a bone fracture, can be prevented. There are basically two ways that a diagnosis of osteoporosis can be made. The first is by experiencing a fragility fracture (a fracture defined as a low trauma fracture, or a fracture occurring when falling from a standing height or lower). The other is by getting a DXA scan and having a T-score of less than or equal to -2.5.

The Arthritis & Osteoporosis Center of Southwest Ohio is a member of the National Osteoporosis Foundation's Professional Partners Network®


References:

  1. National Osteoporosis Foundation - Fast Facts on Osteoporosis. www.nof.org. Accessed 2/2009.
  2. The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center. "Osteoporosis Overview". Accessed 2/2009
  3. Bone Health and Osteoporosis: A Report of the Surgeon General; www.surgeongeneral.gov 10/14/2004.
  4. International Osteoporosis Foundation: "What is Osteoporosis?" www.iofbonehealth.org Accessed 2/2009.
  5. WHO Fracture Risk Assessment Tool. www.shef.ac.uk/FRAX