Early DEXA Screen Identifies Osteoporosis
An estimated 75 million people suffer from osteoporosis in the United States, Europe and Japan. Osteoporosis is blamed for 2.3 million fractures annually in the United States and Europe.
Christopher Wise, MD, director of orthopedic trauma for North Kansas City Hospital, treats and repairs a growing number of fractures due to osteoporosis. With our extended life expectancy, sedentary Western lifestyle and aging population, osteoporosis-induced fractures are estimated to increase from 1.66 million in 1990 to 6.26 million by 2050.
Dr. Wise recommends that physicians increase their use of DEXA screening, the tool used to diagnose bone density. Too often, this osteoporosis screen is ordered after someone has a fracture. These initial fractures could be prevented, however, if more people were tested as a preventive measure.
“Often patients with fractures tell me someone suggested osteoporosis screening, but they never asked their primary care provider about it,” Dr. Wise says . “We focus on mammograms and pap smears, but as physicians we need to cast a wider net. I think we drop the ball on screening for osteoporosis, and it is going to be a big problem with baby boomers hitting the age for fragility fractures.”
Preventing fractures is a major concern for older adults. According to the U.S. Preventive Services Task Force, approximately 12 million Americans over the age of 50 have osteoporosis. One half of women will have a fracture after going through menopause. Hip fractures, in particular, can cause chronic pain, lowered quality of life, and increased mortality. The task force notes that hip fractures increase mortality 12–20%, and 20–40% of patients die within a year of a hip fracture.
The sites most common for osteoporosis fractures are:
- Proximal femur
- Vertebral bodies
- Distal forearm
The first step is identifying patients at high risk. The online FRAX assessment tool can help identify those who have a high risk of fracturing. Once identified, those at risk can be treated to prevent the disease.
So who should be screened as a preventive measure? Dr. Wise says high-risk factors include:
- Increased age (Hip fractures rise significantly after age 70.)
- Gender: females>males
- Genetics: Caucasian>Asian>African-American
- Family history
- Body size: petite/thin are at high risk
- Life style: tobacco use, alcohol abuse, sedentary, malnutrition, lack of sun exposure, some medications
Osteoporosis is a preventable disease. The entire human skeletal system is completely replaced every 2-3 years, so it’s never too late to start therapy. Multiple interventions are recommended to reduce the chance of Osteoporosis onset:
- Adequate calcium and vitamin D
- Weight-bearing and muscle-strengthening exercise
- Cessation of tobacco use
- Treatment of alcoholism
- Treatment of other risk factors
Christopher Wise, MD
After completing medical school at Saint Louis University School of Medicine, Dr. Wise completed a residency in orthopedic surgery at Michigan State University and an orthopedic traumatology fellowship at Carolinas Medical Center. Dr. Wise is a member of AO North America, a society dedicated to the advancement of fracture care. He has a special interest in complex fractures of the pelvis and lower extremities.
To learn more, call 816-561-3003.