Osteoporosis / Osteopenia

Osteoporosis causes the bone to become fragile and break (fracture) with minimal or low trauma. It occurs more commonly in women following bone loss in menopause but is also found in 20% of men with aging and can be caused by a number of other diseases, including rheumatoid arthritis and medications such as steroids. 

Osteoporosis is a silent disease but can be identified using a DXA study before fractures occur.  It is not uncommon for people to confuse the condition with osteoarthritis (a type of degenerative arthritis) and mistake DXA for a bone scan (which instead measures blood flow to bones in the skeleton to evaluate for inflammation). 

As performed at AOCC, a DXA study will often be accompanied by assessing the connectivity of bone using TBS (trabecular bone score) and for the presence of prior silent spinal fractures using VFA (vertebral fracture assessment). Reassuringly, the radiation exposure from DXA/VFA/TBS is very low and equivalent to flying on a plane from New York to Los Angeles.

Using your detailed history coupled with DXA/VFA/TBS, providers at AOCC can accurately define your future fracture risk and recommend the best therapy tailored to you. A daily calcium intake of 1000-1200 mg in food and/or anabolic supplement, a daily vitamin D3, and regular weight-bearing exercise such as walking and balance training for fall prevention is typically recommended. 

Treatments for osteoporosis fall into 2 broad classes: anti-resorptive that prevent bone loss, such as weekly or monthly oral Fosamax/alendronate, Actonel/risedronate, Boniva/ibandronate, iv zoledronate, which can be given as an in-office infusion once a year for 1-5 years or Prolia which can be given as an in-office injection every 6 months and anabolic or bone-building drugs like Forteo, Tymlos which are given as injections at home nightly for 18-24 months or Evenity which is given as an injection in the clinic monthly for 1 year. 

 

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