In osteoporosis, bone breakdown outpaces bone building, so bones become thin and porous. It causes no symptoms until a bone breaks.
Who is at risk
Risk rises with age, female sex after menopause, low body weight, smoking, heavy alcohol use, long-term steroids and a family history of hip fracture.
Typical fractures
Fragility fractures happen after a fall from standing height or less. The classic sites are the hip, the spine (vertebral compression fractures) and the wrist.
Diagnosis
A DEXA scan measures bone mineral density and reports a T-score compared with a healthy young adult. A T-score of -2.5 or lower means osteoporosis.
Treatment
Calcium, vitamin D, weight-bearing exercise and quitting smoking help every patient. Medicines such as bisphosphonates slow bone loss and lower fracture risk.
| T-score | Category | What it means |
|---|---|---|
| -1 or higher | Normal | Bone density close to a young adult |
| Between -1 and -2.5 | Osteopenia | Low bone mass, higher risk |
| -2.5 or lower | Osteoporosis | High fracture risk |
At the bedside
A vertebral compression fracture may show as height loss, a stooped back or sudden back pain after a minor strain. Assess fall risk in every older adult, because preventing the fall prevents the fracture.
Related guides
Written by Making Synapses. Topic reference: OpenStax, Anatomy and Physiology 2e (no text adapted).