What is Osteoporosis?
Osteoporosis is a complex, multi-factorial disease characterized by decreased bone density and increased bone fragility, resulting in susceptibility to fractures. This silent, progressive disease may advance in a person for decades without exhibiting any symptoms. In fact, a person may never experience a symptom at all until a fracture occurs.

Early detection and intervention are crucial, as bone loss is a factor that may be modified in mid-life to reduce fracture risk. With treatment, bone loss can be reduced. However, once bone is lost, it is extremely difficult to restore the microarchitecture of the skeleton.
Osteoporosis was once considered an inevitable consequence of aging, however, with new techniques for early detection and ever-increasing treatment options, osteoporosis management can and should be part of your practice today.

Who is at risk?
In the United States, over 28 million people are at high risk of developing osteoporosis, with risk to women being the greatest. After menopause, a woman’s chances of suffering an osteoporotic spine or femur fracture are 30% or three times that of a man’s. In fact, one third of Caucasian women over the age of 50 have osteoporosis, yet nearly 80% remain undiagnosed. Up to 1.5 million fractures a year are attributable to osteoporosis, with health care expenditures exceeding $14 billion per year.

What is the role of Densitometry?
Bone densitometry is an indispensable tool in Osteoporosis management; assisting physicians in diagnosis and fracture risk assessment, as well as monitoring response to therapy.

Diagnosis of Osteoporosis:
When using bone densitometry, physicians categorize patients as either normal, osteopenic, or osteoporotic, according to classifications set by the World Health Organization (WHO). The critical variable in diagnosis is what is known as the patient’s “T-Score” (comparison to the young adult reference). Normally, both femurs and the spine are assessed, and diagnosis is made using the lowest T-score. In addition to the T-score, patient examination is key in diagnosing osteoporosis.

Fracture Risk Assessment:
Bone mineral density (BMD) is the strongest indicator in assessing fracture risk. As BMD decreases, the risk of fracture is increased exponentially. Femur BMD is recognized as the most accurate predictor of fracture risk, and also has the highest morbidity, mortality and cost of all osteoporotic fractures. A decrease of 1 standard deviation (SD) in femur BMD corresponds to approximately a 3x increase in femur fracture risk. In comparison, an SD decrease in spine BMD corresponds to a 2x increase in spine fracture risk.

Clinical Guidelines:
The World Health Organization (WHO) has established definitions based on bone density measurement at any skeletal site.