Recently HHMP in partnership with Osteoporosis Solutions Australia completed screening of over 170 at risk patients at HHMP. This is an impressive achievement for a 1 week program focused on 1 general practice. Multiple patients with previously undiagnosed osteoporosis have been identified and can now receive appropriate treatment hopefully preventing them from having serious fractures in the future.
An international consensus definition states: “Osteoporosis is a systemic skeletal disease characterised by low bone mass and micro architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture”
The most common reasons for osteoporosis in older women are:
Bone loss in men is in part due to the causes outlined in b) and c) above.
Secondary osteoporosis is a reduced bone mass caused by conditions other than age. Such conditions can include but are not limited to: anorexia, diabetes, hormone disorders, alcoholism, liver problems, gastric disease, vitamin D deficiency, malabsorption, various medications such as corticosteroids, Crohn’s disease, multiple myeloma and many more.
The World Health Organisation has further defined osteoporosis according to the T-scores from a DEXA assessment for post menopausal women.
Normal bone mass is defined as any BMD that is greater than one standard deviation below the young adult mean. (T-score > -1)
Reduced bone mass (osteopenia) is defined as any BMD between one and two and a half standard deviations below the young adult mean. (-1.0 > T-score > -2.5)
Osteoporosis is defined as any BMD less than two and a half standard deviations below the young adult mean. (T-score < -2.5)
The DEXA assessment measures at least two skeletal sites such as the lumbar spine and the femoral neck regions. Occasionally the forearm is also tested if one of the other two sites cannot due to hip replacement or excessive spinal deformities.
Several treatment options are available for osteoporosis. These include lifestyle and medication options. If there is a medical cause for the osteoporosis eg: a medical conditions such as hormone issues fixing these is the first step. After that multiple oral and injectable medication options are available and may include calcium, vitamin D and anti-resorptive medications.
