Osteoporosis :Symptoms and Signs, Tests and diagnosis, Consequences and Complications


Osteoporosis does not cause symptoms until bone breaks (fractures) and patients may not be aware of their osteoporosis until they suffer a painful fracture.

November 16, 2017

Osteoporosis :Symptoms and Signs, Tests and diagnosis, Consequences and Complications

Osteoporosis does not cause symptoms until bone breaks (fractures) and patients may not be aware of their osteoporosis until they suffer a painful fracture.

Symptoms and Signs of Osteoporosis:

The symptom associated with osteoporotic fractures usually is pain and the location of the pain depends on the location of the fracture. Commonly affected areas are the hip, a wrist, or spinal vertebrae. Fractures of the spinal vertebra can cause severe band-like pain that radiates from the back to the sides of the body. Repeated spinal fractures can lead to chronic lower back pain. Due to collapse of the vertebraeas this will result in loss of height and/or curving of the spine. This gives a hunched-back appearance of the upper back usually in elderly women often called a dowager hump.
Minimal trauma or stress fracture can occur during the course of normal activity such as fractures of the feet while walking or stepping off a curb.
Usually hip fractures  occur as a result of a fall. With osteoporosis, hip fractures can occur as a result of trivial slip-and-fall accidents. Because of poor healing of the bone in patients with osteoporosis ,hip fractures may heal slowly or poorly after surgical repair.

Consequences of Osteoporosis:

Considerable pain, lost workdays, decreased quality of life and disability are the consequences of osteoporosis. Patients suffering a hip fracture will require long term nursing home care. Due to prolonged bed rest after the hip fracture, elderly patients can develop pneumonia and blood clots in the leg veins that can travel to the lungs (pulmonary embolism). Osteoporosis has even been linked with an increased risk of death. Once a person has experienced a spine fracture due to osteoporosis, he or she is at very high risk of suffering another such fracture in next few years.

Tests and diagnosis:

Considering the patient's family history and their risk factors, a scan can be done to measure bone mineral density (BMD).
Dual energy X-ray absorptiometry (DEXA) and bone densitometry can be used for measuring BMD. It can also help monitor response to treatment.
There are two types of device that can carry out a DEXA scan:

  • A central device which is a hospital based scan that measures hip and spine bone mineral density while the patient lies on a table.
  • A peripheral device is a mobile machine that tests bone in the wrist, heel, or finger.

DEXA test takes only 5 to 15 minutes to perform, exposes patients to very little radiation  which is less than one-tenth to one-hundredth of the amount used on a standard chest X-ray), and is quite precise.
The bone density of the patient is compared to the average peak bone density of young adults of the same sex and race and the score is called the T score.
If the T-score is

  •     -1.0 or above is normal
  •     from -1.0 to -2.5 suggests mild bone loss
  •     -2.5 or below indicates osteoporosis

A lateral vertebral assessment (LVA) may be recommended for an older patient who is more than one inch shorter than they used to be, or who has back pain that is not related to another condition.
An ultrasound scan of the heel bone is another way to assess for osteoporosis because the bones appear much thinner and lighter than normal bones. It is less common than DEXA and can be carried out in the primary care setting.

Complications:

As bones become weaker, fractures occur more frequently, and, with age, they take longer to heal. As bones in the spine begin to collapse, this can lead to ongoing pain and loss of stature.  A broken hip can be hard to recover from, and the person may no longer be able to live independently.
Tips to prevent falls for the people with osteoporosis include:

  • ensuring there is plenty of light in the home
  • practicing exercise that helps with balance
  • asking the doctor to review medications, to reduce the risk of dizziness
  • removing trip hazards, such as throw rugs and clutter
  • installing grab bars
  • having regular vision screenings and keeping eyewear up to date