Osteoporosis, a silent disease

Written by: Dr. Ramón Costa Dalmau
Published: | Updated: 14/11/2018
Edited by: Top Doctors®

Osteoporosis is a skeletal disease characterized by impaired bone strength leading to an increased risk of fractures.

Its prevalence in Spain is around 4% of the population according to a study. Causes and Treatment "height =" 146 "src =" / files / Image / large / 57cd9254-6874-4e0b-bad0-4eea8ac97da0.jpeg "style =" float: right "width =" 182 "/> epidemiological made by the Company Spanish of Rheumatology. Therefore, it is estimated that the population over 50 years, one of every three women and one in eight men will suffer at least one fracture due to osteoporosis.

The typically fractured bones are the radius, vertebrae, ribs, femur, pelvis and humerus.

The social and health repercussions of this pathology is remarkable as 1 in 200 people over 50 years in our environment is the femur fracture. This hip fracture is the most serious, because it implies a mortality of 20% in the short term and those who suffer a loss of personal autonomy in 50% of survivors. The cost of health care for hip fractured femur is estimated at 20,000 euros.

Despite these data osteoporosis is underdiagnosed disease, i nfravalorada and in which patients are not properly meet the treatment administered. In fact, in the last 5 years they are seeking 40% less than women of osteoporosis.


Causes of Osteoporosis

Osteoporosis can be called a silent disease because for years reduced bone strength occurs without any symptoms.

It usually affects postmenopausal women, because their bones are less strong than those of men being less thick, bulky and with a lower bone mineral density. These characteristics confer less resistance to fracture even at young ages.

Subsequently, menopause, estrogen hormones called primary female body almost disappear and, among other effects, an acceleration occurs in the renewal of the bones is not completed and appears to osteoporosis.

To diagnose this disease we have bone densitometry. Although it is a test limitations, it remains the main method of diagnosis of the disease. It is also used as a method of monitoring and evaluating the effectiveness of treatments. Bone densitometry is to apply a variant of X rays in the lumbar spine and the femoral head for their bone mineral density.

The main risk factors for osteoporosis are:

  • Age.
  • He has already suffered a fracture.
  • History of hip fracture in a first-grade.
  • Low bone mineral density measured by densitometry.
  • Present high risk of falling.
  • Perform treatment with cortisone derivatives.
  • Have low body weight.
  • Smoking and alcoholism (alcoholism) assets.
  • We must remember that there are racial factors: Asians are more fragile than European bones.
  • Osteoporotic fractures that have happened to a person you greatly increase the risk of suffering new fractures.


Diagnosis of osteoporosis

The diagnosis of osteoporosis des two views is performed:

  1. Clinical diagnosis: the presence of fragility fractures acquired and triggered by moderate injuries.
  2. Densitometric diagnosis: the FRAX method is the most widely used to estimate the risk of bone fracture. The FRAX combines clinical and densitometric data by calculating the patient's risk to suffer a fracture in the next 10 years. His determination helps determine the need for drug treatment of osteoporosis, analyzing the characteristics of each patient.


Osteoporosis Treatment

As for the treatment of osteoporosis, it is based on avoiding the occurrence of fractures and should be individualized to the circumstances of each patient. Some steps to improve osteoporosis are:

First, must be modified reversible factors that can be controlled by the patient's habits, such as not smoking, moderate alcohol and coffee, diet rich in foods containing calcium, avoid drugs that weaken bones, prevent falls moderately sunbathing and performing moderate physical exercise regularly as walking or cycling.

The use of appropriate analgesics if painful fractures active, although their half succeeded by bone fragility vertebral fractures are asymptomatic.

The correction of vitamin D levels is already one of the mainstays of treatment, given its high frequency and important implication of vitamin D deficits in the development of osteoporosis.

The drugs used are able to improve bone mineral density, reducing the risk of vertebral fracture and some of them also reduce the risk of femoral fracture. The most used are bisphosphonates, which have received much criticism in recent years by the emergence of side effects such as osteonecrosis of the jaw and the appearance of atypical femoral fractures in very isolated cases. The estimated risk of ONJ in osteoporotic patients round one case per hundred thousand treaties. For atypical fractures, the ratio is an atypical femur fracture by over hundred osteoporotic fractures prevented.

Therefore no doubt in cases requiring drug treatment, being highly useful patient monitoring to improve compliance and to assess the effectiveness of treatment are obtained.

*Translated with Google translator. We apologize for any imperfection
Dr. Ramón Costa Dalmau

By Dr. Ramón Costa Dalmau

Renowned specialist in rheumatology, Dr. Costa Dalmau is also expert in personal injury. He graduated in inflammatory rheumatism and systemic diseases from the University of Montpellier and also has a master's degree in Valuation of bodily harm and medical experts from the University of Barcelona. He is a member of various medical societies and has participated in numerous conferences and symposia.

*Translated with Google translator. We apologize for any imperfection