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Bone Health: Diagnosis and Treatment
Dr D Raghu Varan, MBBS MS Ortho, consultant trauma and joint replacement surgeon, from Padma Nursing Home, Karmanghat talks about osteopenia and osteoporosis, a condition that represents a continuum of bone health disorders
Osteopenia and osteoporosis represent a continuum of bone health disorders characterised by decreased bone mass and disrupted bone microarchitecture. They commonly occur due to increased age, menopause, and metabolic abnormalities.
Diagnosis is typically made using a lumbar-based DEXA scan, which measures bone mineral density and assigns T-scores. Osteopenia is defined as a T-score between 1 and 2.5 standard deviations below peak bone mass. In comparison, osteoporosis is diagnosed when the T-score exceeds 2.5 standard deviations below peak bone mass.
Several risk factors contribute to the development of osteopenia and osteoporosis. These include a sedentary lifestyle, being a Caucasian woman of northern European descent, smoking, low body weight, inadequate protein intake, heavy alcohol consumption, positive family history, premature menopause, and breastfeeding with low vitamin D diets.
Treatment of osteopenia and osteoporosis involves a multidisciplinary approach. Lifestyle modifications play a crucial role and include:
• Regular exercise.
• Avoiding smoking and excessive alcohol consumption.
• Adequate sunlight exposure.
• A protein-rich diet.
Pharmacologic agents are often prescribed to manage these conditions. Treatment options may include calcium and Vitamin D supplementation, bisphosphonates, hormone replacement therapy (HRT), salmon calcitonin, and specific injections like teriparatide, denosumab, and romosozumab. These medications help increase bone mineral density and reduce the risk of fractures.
By understanding the risk factors, timely diagnosis, and available treatment options, individuals can take proactive steps to maintain healthy bones and prevent fractures associated with osteopenia and osteoporosis. Consulting with healthcare professionals for personalised guidance and treatment plans is important.
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