Osteoporosis

Screening and Treatment

What is osteoporosis?

Osteoporosis is a medical condition characterized by weakened bones that become more fragile and are at a higher risk of breaking. This occurs because of a decrease in bone density and changes in bone structure. The disease often develops gradually and may not show symptoms until a bone fractures, which can be due to minimal trauma or stress. Osteoporosis is commonly associated with aging, but other factors such as hormonal imbalances, nutritional deficiencies, certain medications, and lifestyle choices can also contribute to its development. The condition is often managed with medications, dietary adjustments, and lifestyle changes aimed at improving bone health and reducing fracture risk.

Who is at risk for osteoporosis?

Risk factors for osteoporosis include:

• Age: The risk increases as people get older, especially for women post-menopause due to a drop in estrogen levels.

• Gender: Women are at higher risk than men, primarily due to hormonal changes after menopause and generally having lower bone density.

• Family History: A family history of osteoporosis or fractures can increase one's risk.

• Body Type: Individuals with a small, thin frame tend to have lower bone mass, which can increase their risk.

• Hormonal Changes: Conditions or treatments that affect hormone levels, such as menopause, thyroid disorders, or prolonged use of corticosteroids, can impact bone health.

• Dietary Factors: Low calcium and vitamin D intake can contribute to decreased bone density.

• Lifestyle Factors: Smoking, excessive alcohol consumption, and a sedentary lifestyle can negatively affect bone health.

• Medical Conditions: Certain chronic diseases, such as rheumatoid arthritis, gastrointestinal disorders that affect nutrient absorption, and some cancers, can increase the risk.

• Medications: Long-term use of medications like corticosteroids and certain anti-seizure drugs can lead to bone loss.

• Ethnicity: Caucasian and Asian women are generally at a higher risk compared to other ethnic groups.

• Medical History: Previous fractures or a history of conditions affecting bone health can be a risk factor.

Who should be screened for osteoporosis?

The National Osteoporosis Foundation currently recommends bone mineral density testing for women:

• Age 65 or older

• Postmenopausal and younger than 65 with certain risk factors for bone loss

• Use of certain medications including long term glucocorticoid use

• History of an adult fracture

• Family history of osteoporosis

• Other risk factors identified during assessment with a health provider

What is a bone mineral density?

Bone mineral density (BMD) screening is a diagnostic test used to measure the amount of minerals (mainly calcium) in a specific volume of bone. This measurement helps assess bone strength and predict the risk of fractures. The most common method for BMD screening is Dual-Energy X-ray Absorptiometry (DEXA or DXA), which is a low-radiation imaging technique. At St. Louis Healthcare Group, we perform DXA scans in office. After you scan, you will have a consultation with Dr. Richard Muckerman, certified by the International Society for Clinical Densitometry. He will interpret your test and provide recommendations, plan of care, and treatment based on your risk factors, personal history, and BMD measurements.