Osteoporosis is characterized by low bone density and loss of bone tissue. This colored scanning electron micrograph shows a reduction in overall bone mass and an increase in bone porosity, making it more brittle and likely to fracture. It commonly affects the elderly and post-menopausal women, who experience a decrease in levels of the hormone estrogen. It may also develop following injury or infection.
Bone Loss_0212 Slideshow
Osteoporosis is often a silent disorder, as many patients do not experience any symptoms until a fracture occurs. Normal bone density reaches it’s peak at age 25 years. After the age of 35 years, both men and women lose 0.3% to 0.5% of their bone density per year as part of the aging process. Asymmetric loss in vertebral body height, without evidence of an acute fracture, can develop in patients with osteoporosis.
The National Osteoporosis Foundation and the AMA recommend a dual energy X-ray absorptiometry scan (DEXA or DXA) to diagnose osteoporosis. The test measures bone density in the patient’s hip and the spine, and then compares it to the average peak bone density in young adults of the same sex and race. WHO criteria define a normal T score as within 1 standard deviation of the mean, osteopenia as -1 to -2.5 SD, osteoporosis as < -2.5 SD, and severe osteoporosis as < -2.5 with fragility fractures.
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Vertebral compression fractures_0212 Slideshow
Repeated osteoporotic vertebral compression fractures can cause chronic lower back pain, and contributes to loss of height and curvature of the spine (pictured here), causing severe “band-like pain that radiates around from the back to the side of the body. This may result in a hunched-back appearance, referred to as a "dowager hump."
HIp Replacement_0212 Slideshow
This color-enhanced X-ray shows a hip replacement in an 83-year-old female patient with osteoporosis. Hip fractures are common among patients with osteoporosis who experience trivial accidents or falls, and are often difficult to heal after surgical repair due to the poor quality of the bone.
Calcium Intake Recommendations_0212 Slideshow
Osteoporosis prevention includes advising patients to quit smoking and drinking alcohol, and encouraging exercise to improve balance and reduce the risk of falls. Treatments include consuming adequate levels of vitamin D and calcium, as defined above by the National Institutes of Health. Milk, yogurt and cottage cheese are good sources of calcium, along with calcium-fortified foods and supplements. Natural sunlight, fortified milk, cheese, butter/margarine, fish and cereal are important vitamin
Osteoporosis affects approximately 10 million Americans, and another 40 million are at risk for the bone disorder. One in two women and one in four men age 50 years and older will experience an osteoporosis-related fracture in their lifetime, with estimated health-care costs totaling approximately $14 billion each year. These numbers are expected to increase as the population continues to age.