Osteoporosis is a chronic condition of the bone where the bone mineral density is lower and the micro-structure of the bone is disordered making the bone weaker. Osteopenia is a thinning of the bone, but not severe enough to meet the criteria for osteoporosis. Bones which have lost their mineral density are at higher risk for fracture.
Bone density scanning, also called dual-energy x-ray absorptiometry (DXA or DEXA) or bone densitometry, is a special form of x-ray technology that is used to measure bone loss. DEXA is considered the standard for measuring bone mineral density.
The T-score is the most significant scoring system in postmenopausal women and reflects a patient's bone density compared with healthy, white women between the ages of 20 and 29 years of age. T-scores less than or equal to -2.5 at the hip, femoral neck, or lumbar spine are diagnostic of osteoporosis.
In the past our concern has been primarily on the loss of bone density in women. Osteoporosis was primarily a concern in postmenopausal women over age 50. It is now known that some men experience a decline in their bone mineral density as they age, if they require chronic use of corticosteroids, or suffer hypogonadal conditions.
Prevention is the most important way to reduce the risk of osteoporosis related fractures. Bone mass density peaks between 25 and 35 years years of age. Physical activity during your teenage years has the greatest impact in reducing your risk of osteoporosis later in life. In adults physical activity can help maintain and actually increase bone mass density. The higher the peak value of your bone density at age 25 the lower your bone loss will be as you age.
A loss of bone density occurs due to an imbalance between bone resorption (which normally occurs) and bone formation. In someone with a decline in their bone density, bone is reabsorbed more quickly or it is formed at a slower rate than necessary to prevent a decline in bone density. Many cases of osteoporosis do not result from inadequate calcium intake, but from other factors such as cigarette smoking, sedentary lifestyle, family history, age over 30, and complications related the use of some medications.
The risk factors that can not be changed include a family history, a history of a bone fractures as an adult, advanced age or European or Asian ancestry. The risk factors that you can change include prolonged use of corticosteroids, smoking, low body weight, low calcium and Vitamin D intake, alcoholism, sedentary lifestyle and poor health.
Restoring the micro-structure of the bone can be difficult once you start experiencing a decline in bone density. Trabecular and cortical are the two types of bone. Trabecular bone appears sponge-like and is at the core of long bones while the cortical bone is the hard exterior shell. When a decline in bone density begins it is the trabecular bone that demonstrates the most bone loss. The hip bone, spine and wrists are the areas of the body which have the most trabecular bone and are at the greatest risk for a loss of bone density and osteoporosis related bone fractures.
If you have suffered a bone fracture, related to osteoporosis, you are at higher risk for subsequent fractures. It is estimated that about 20 percent of those suffering a hip fracture die within a year. The risk of death is usually related to other complications associated with osteoporosis and fractures. A hip fracture will often result in decreased mobility and an additional risk of pulmonary embolism. A Pulmonary embolism is a blood clots that travels to the lung and obstructs blood flow. The blood clot usually originates in the lower extremity of someone suffering a fracture or injury to the lower extremity. The consequences of the embolism can be chest pain, respiratory distress and even death.
Osteoporosis also affects the spine, resulting in an increase in curvature. This increased curvature may affect your ability to breath appropriately and increase your risk of falling. Compression fractures of the spine can result in severe pain, and prolonged hospitalization.
Osteoporosis is a disease that crosses gender, age, social and economic barriers. Everyone is potentially at risk for developing osteopenia or osteoporosis. It is imperative that you take the steps necessary to improve your health, exercise, maintain an adequate intake of calcium and vitamin D. The DEXA scan will help you determine your baseline bone density. Medications are available to help slow down bone loss and increase bone mineral density.
Osteoporosis is not a disorder that you should delay in taking the steps to treat. Optimizing your bone density can take time and the earlier you begin, the lower your risk of developing osteoporosis as you age. This will also lower your risk of fractures, complications related to fractures and possibly death.