Osteoporosis does not develop overnight. Bone mass can be lost steadily for many years without experiencing any symptoms or signs of the disease until a bone fractures. For this reason, osteoporosis is often called “the silent thief” – literally stealing our bone mass without giving us any indication whatsoever. If osteoporosis is first diagnosed at the time a fracture occurs, it is already fairly advanced. A fragility fracture is the most significant clinical consequence of osteoporosis, and therefore preventing a fracture, or the second fracture if one has already occurred, is of paramount importance.
Who should be assessed for risk fracture?
- Women and men over 50 to identify those at high risk
- Anyone over 50 who has experienced a fragility fracture
How is the Assessment Done?
- Detailed history to identify risk factors for low BMD, future fractures and falls:
- Prior fragility fracture
- Parental hip fracture
- Glucocorticoid use
- Current smoking
- High alcohol intake (3 or more drinks per day)
- Rheumatoid arthritis
- Inquire about falls in past 12 months
- Inquire about gait and balance
- Measure weight
- Screening for vertebral fractures:
- Measure height annually
- Measure rib to pelvis distance
- Measure occiput-to-wall distance
- Spinal x-ray indicated if there is evidence of vertebral fracture
- Assess fall risk by using Get-Up-and-Go-Test