What is osteoporosis?
Osteoporosis is a common condition where a decrease in the amount of bone in the skeleton, measured as decreased bone density, leads to increased risk of breaking a bone (fracture). Osteoporosis does not have early symptoms and the first clinical sign of the condition is a broken bone, or loss of height as vertebrae fracture.
Low bone density is called osteopenia which is the bone density category between normal and osteoporotic. In patients with osteopenia, monitoring every 2-3 years is recommended.
At age 60 women have approximately a 60% chance of developing an osteoporotic fracture in their remaining lifetime, while a man has a 30% chance. After the most severe osteoporotic fracture, a hip fracture, less than one third of individuals return to their previous independent life style.
Risk factors for osteoporosis
- Aging. Fracture risk especially increases after age 70
- Previous minimal trauma fracture
- Family history of osteoporosis
- Prolonged low calcium intake
- Early menopause (45 years or younger)
- Malabsorption (e.g Coeliac disease or Crohn's disease)
- Low testosterone in men
- Hyperthyroidism or hyperparathyroidism
- Low body weight
- Current tobacco use and increased alcohol intake (3 or more alcoholic drinks per day)
- Prolonged steroid therapy (e.g. prednisone, cortisone)
- Rheumatoid arthritis
- Chronic liver or kidney disorders
How is osteoporosis diagnosed?
Osteoporosis is diagnosed using a DXA scan. This type of scan is currently the gold standard in diagnosis and treatment of osteoporosis, is minimally invasive and less time consuming than other methods of bone density testing.
DXA uses a very low dose of X-rays to measure your bone density. The lower spine and both hips are usually scanned. If body composition is requested a whole body scan is performed.
St Vincent's Clinic Densitometry also provides Lateral Vertebral Assessment (LVA). This test is performed within the same appointment and takes approximately 4 minutes. The purpose of this extra scan is to screen for possible previous vertebral fractures, which may have gone unnoticed, but are an important marker of higher risk of fracture.
The DXA appointment usually takes 15-20 minutes. You will be asked to take off any metal objects (such as a belt, underwire bra, body piercings, watch) and in some cases asked to wear a gown.
Above: Lumbar spine DXA image
Above: Proximal femoral (hip) DXA image