What is Osteoporosis
Osteoporosis is a condition characterized by a
decrease in the density of bone, decreasing its strength and
resulting in fragile bones. Osteoporosis literally leads to
abnormally porous bone that is compressible, like a sponge. This
disorder of the skeleton weakens the bone and results in frequent
fractures (breaks) in the bones.
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 fracture can
be either in the form of cracking (as in a hip fracture) or
collapsing (as in a compression fracture of the vertebrae of the
spine). The spine, hips, ribs, and wrists are common areas of bone
fractures from osteoporosis although osteoporosis-related
fractures can occur in almost any skeletal bone.
How is osteoporosis diagnosed?
A routine X-ray can reveal osteoporosis of the bone because the
bones appear 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. Thus, the appearance
of the bone on X-ray often is 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 recommend a
dual-energy X-ray absorptiometry scan (DXA, formerly known as DEXA)
for diagnosing osteoporosis. DXA measures bone density in the hip
and the spine. The test takes only five to 15 minutes to perform,
exposes patients to very little radiation (less than one-tenth to
one-hundredth of the amount used on a standard chest X-ray), and
is quite precise.
The bone density of the patient is compared to the average peak
bone density of young adults of the same sex and race. This score
is called the "T score," and it expresses the bone density in
terms of the number of standard deviations (SD) below peak young
adult bone mass.
How is
osteoporosis treated and prevented?
The goal of treatment of osteoporosis is the prevention of bone
fractures by reducing bone loss or, preferably, by increasing bone
density and strength. Although early detection and timely
treatment of osteoporosis can substantially decrease the risk of
future fractures, 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. Osteoporosis treatment and prevention measures are
1. lifestyle changes, including quitting cigarette smoking,
curtailing excessive alcohol intake, exercising regularly, and
consuming a balanced diet with adequate calcium and vitamin D;
2. medications that stop bone loss and increase bone strength,
such as alendronate (Fosamax), risedronate (Actonel), raloxifene (Evista),
ibandronate (Boniva), calcitonin (Calcimar), and zoledronate (Reclast);
3. medications that increase bone formation such as teriparatide (Forteo).
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