Osteoporosis means soft and fragile bones.  The skeleton is dynamic in that bone is continuously being laid down and taken away by highly specialised bone cells.  This process is normally in balance.  When more bone is taken away than laid down Osteoporosis occurs.


Osteoporosis is a silent symptomless disease and the only time you will be aware of it is when a complication occurs and this is a fracture.


Strange as it may seem, when a baby is born it has little bone in its skeleton.  increasing bone content is deposited in the skeleton which reaches a maximum at about the age of thirty years.




We need to diagnosed bone content and quality.  The latter is difficult to assess accurately so we measure bone content which an be assessed without difficulty.


For this we use a DEXA scan which uses a highly specialized X-ray machine which uses a very low dose of harmless X-rays to measure the bone content in the skeleton measured in Grammes per square centimetre.  As defined by the WHO, the results are issued as a statistic which is related to a data base derived from the maximum bone content at the age of 30 years.  These are called T-scores and depending on the level below the norm. at 30 we diagnose Osteopaenia (Mild bone loss), Osteoporosis or severe osteoporosis when an associated fracture is present.


it cannot be assessed on an X-ray film unless extremely severe.  CT can make the diagnosis but is cumbersome and expensive.


Because it is symptomless all women at about age 50 are advised to have a DEXA scan and men at about 60.


All middle aged people getting tooth implant posts should be DEXA scanned prior to surgery because osteoporosis of the jaws are so common and result in ‘post’ failures.





Osteoporosis affects approximately 33% of menopausal women.

Osteoporosis results in fractures which with advancing age become painful, debilitating, deforming and even fatal.


There will be 400,000 potentially preventable osteoporotic hip fractures in the European Community this year.  These require hip replacement therapy and about 20% are fatal.


Thus, osteoporosis is a major social problem world wide and is majorly under diagnosed be cause it is symptomless.  Hence it is caused the silent killer


 Osteoporotic fractures are see commonly e.g. the Dowager Hump in the spine, fractures around the wrists and hip fractures.  In our society approximately 10% of women aged 50 years already have a symptomless spinal fracture.


More osteoporotic fractures occur in women than breast, ovarian and uterine cancer combined! 




Men also get osteoporosis but at a later stage and the reason we see less in men is simply because they don’t live as long as women.  The hip fracture incidence in men therefore, approaches that in women.



Mostly unknown and poorly understood.  We do know however that there is a sharp increase in the incidence of Osteoporosis in the female menopause and this is thought to be due to Oestrogen deficiency. 

Lifestyle is important especially with regard to Diet and Exercise.


Lack of Vitamin D and sunlight


Certain diseases such as Parathyroid tumours.


Alcohol abuse and certain drugs especially Cortisone.




Disuse  e.g bed ridden disease, treatment of fractures Astronauts in zero gravity.




Try and find the cause especially in young persons.


Hormone Replacement Therapy


Specific Drugs such as: -   the Alendronates.....1 table weekly;  Zoledronic Acid.....1 injection annually;  Protos.....daily oral therapy;  Forteo a parathyroid extract.......very expensive but effective and reserved for serious cases with fractures. 


Education, especially in the prevention of falls


Calcium supplementation and Vitamin D.


Weight bearing exercise.


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