From the Guidelines
Osteoporosis signs and symptoms are often silent, but may include fragility fractures, pain, and deformity.
Common Signs and Symptoms
- Fragility fractures, which are fractures that occur after a low-level trauma, such as a fall from a standing height or lower 1
- Pain and deformity at the time of the injury 1
- Loss of bone mass and impaired bone microarchitecture, which can lead to a substantially increased risk of fracture 1
- Vertebral fractures, which may be clinically silent, but can be identified through dedicated vertebral imaging and review of past imaging 1
Risk Factors
- Increasing age, with men over 50 years being at higher risk 1
- Low body weight, with a body mass index <20 to 25 kg/m2 or lower 1
- Weight loss, with a loss of >10% of body weight 1
- Physical inactivity, with a lack of regular physical activity 1
- History of parental hip fracture, ethnic background, and previous clinical or morphometric vertebral fracture 1
Diagnosis
- Dual-energy x-ray absorptiometry (DXA) is the current gold standard test for diagnosing osteoporosis in people without an osteoporotic fracture 1
- DXA measures bone mineral density (BMD) and reports results as T scores, with a T score of –2.5 or lower indicating osteoporosis 1
- Fragility fractures can also be used to diagnose osteoporosis, even in the presence of a well-maintained bone mineral density 1
From the Research
Signs and Symptoms of Osteoporosis
- Osteoporosis is often referred to as a "silent disease" because it lacks symptoms or signs until a fracture has occurred 2, 3, 4.
- The earliest symptom of osteoporosis is often an episode of acute back pain caused by a pathologic vertebral compression fracture, or an episode of groin or thigh pain caused by a pathologic hip fracture 5.
- Clinical or subclinical vertebral fractures are associated with a 5-fold increased risk for additional vertebral fractures and a 2- to 3-fold increased risk for fractures at other sites 6.
- Any new fracture in an adult aged 50 years or older signifies imminent elevated risk for subsequent fractures, particularly in the year following the initial fracture 6.
Common Forms of Osteoporosis
- Postmenopausal osteoporosis (Type I) and age-related osteoporosis (Type II) are the most common primary forms of bone loss seen in clinical practice 5.
- Secondary causes of osteoporosis include hypercortisolism, hyperthyroidism, hyperparathyroidism, alcohol abuse, and immobilization 5.
Diagnosis and Treatment
- Osteoporosis is diagnosed through different methods such as bone densitometry and dual X-rays 4.
- The treatment of osteoporosis focuses on different aspects, including pharmacological treatments, such as anti-resorptive drugs, and non-pharmacological treatments, such as lifestyle habits, including physical activity, diet, and the cessation of harmful habits 4, 6.