Saturday, September 1, 2012

Osteopenia: Silent But Serious

Typically, we don't consider osteopenia (T-score of -1.0 to -2.4) as a serious threat to our health, but maybe we should. In a recent study out of the UK (Lynn et al., 2012) the authors found fractures in osteopenic individuals not to be uncommon. Distal long bones (such as the forearm, tibia, fibula and metatarsals) were the most common fracture sites. Interestingly, 45% of the individuals in this study were on bone protection treatment of some type at the time of their fracture.

The authors concluded that "careful clinical evaluation and a FRAX score assessment are important in patients with fragility fractures even when they have a category of osteopenia by DXA scan."

I have been telling patients for years how important it is to detect bone loss early. Having your first DXA scan at an earlier age (40 instead of 50 as is often recommended by physicians), and definitely if you sustain any minimal-trauma fracture, is good insurance for early detection of bone health issues. I can't tell you how many of my patients have had a metatarsal (foot) fracture from low-mileage running but their family physician did not follow up with a DXA scan to assess bone mineral density. Since it is so much easier to stop bone loss rather than to gain it back, why not find out if there is a problem BEFORE it becomes full blown osteoporosis? Osteopenia is always easier to work with than osteoporosis; there is valuable time to find solutions.

Lynn, M., Brannigan, S., Moniz, C. 2012. Osteopaenia: silent but serious threat for bone health - retrospective analysis of fragility fractures in osteopaenic patients. Osteo Int (Abstracts of the Osteoporosis and Bone Conference 2012) 23(Suppl 5):P92.
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