Osteoporosis
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Bone Density Tests: A Weapon Against Osteoporosis

The Hidden Causes of Osteoporosis


By: Kendra Kaye Zuckerman, MD

Introduction
Millions of Americans have osteoporosis, but while this common condition is both preventable and treatable, it often goes undetected because it has no symptoms.

In medical textbooks osteoporosis is defined as "a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk." In essence this means that osteoporosis is a disease in which the bones become thin (or brittle) and therefore can break more easily. Osteoporosis results in 1.5 million fractures each year.

Bone physiology


Bone is a living tissue that is constantly changing. Throughout childhood and adolescence, bone density increases. (Bone density is also referred to as bone mineral density or bone mass, and can be thought of as "bone strength.") This continues until approximately 25 or 30 years of age when peak bone mass is reached. This maximum bone mass varies from person to person, but in general, women reach a lower peak bone mass than men. After this peak is reached, bone mass begins to decline, and each year the bone becomes a little bit less dense (or less strong). When women go through menopause and estrogen levels fall, there is an accelerated loss of bone that can last for 5-10 years.

Clinical features

There are no symptoms of osteoporosis. Most people, therefore, are unaware that they have it until they sustain a fracture. (Many people confuse osteoporosis with osteoarthritis but these are very different conditions. Osteoarthritis is the most common type of arthritis, causing pain and stiffness in affected joints, whereas osteoporosis is a thinning or weakening of the bones and can lead to fractures.)

The danger of osteoporosis lies in the fractures that can result. Vertebral (or spinal) fractures are the most common consequence of osteoporosis and often cause back pain. As a person has more spinal fractures, he or she may develop a "dowager's hump," a protuberant abdomen, and as much as 4 to 8 inches in height loss. However, it is hip fractures that are the most serious outcome of osteoporosis. Up to 20% of people who have a hip fracture die within one year and more than 50% of the survivors are unable to return to independent living. The pain and loss of independence caused by fractures can result in poor self-esteem, depression, and a feeling of hopelessness.

Who is affected?

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