Osteoporosis literally means ‘Porous Bones’. It occurs when the rate of bone renewal does not match the rate of breakdown, eventually resulting in weak, brittle bones. Sufferers generally do not realise they have the condition until they break a bone, by which time it is too late for them to take the most effective action1. Often, the condition is a result of a lifetime’s failure to take preventative measures: Osteoporosis has been referred to as a ‘Pediatric disease with geriatric consequences.’2
Facts and figures
The incidence of osteoporosis has almost doubled in the last 30 years3. In Britain in 1995 there were 200,000 osteoporosis related fractures a year, costing £750 million3. This is predicted to rise to 2.1 billion by 20204. This is without the indirect costs, such as pain, time off work, lost productivity, and the untold social effect on the families of patients.
Estimates vary, however it has been stated that after the age of 50, 1 in 2-3 women, and 1 in 5-12 men in the UK will sustain a fracture, in the main due to osteoporosis4. In fact, more women die each year from osteoporosis than die from cancer of the ovaries, uterus and cervix combined8. This is a frightening and unnecessary statistic for a condition that is both preventable and treatable.
The World Health Organisation suggests that health promotion and preventative measures are crucial for containing the effects of osteoporosis on the world population6,7.
Of all of the fractures that occur as a result of osteoporosis, hip fracture is the most serious. One-fifth of hospital beds are occupied by people with hip fractures, and the combined cost of hospital and social care for patients with a hip fracture amounts to more than £1.73 billion per year in the UK4. Depending upon the estimate, white, postmenopausal women have a one in six or one in seven risk of sustaining a hip fracture in their lifetime4,9. This is higher than the risk of developing breast cancer4. Out of four women that suffer this type of fracture, only one will ever recover completely; the rest will suffer permanent disability10. Typically one in four will die within a year. The worst news, though, is that 80% of older women would rather die than experience the pain, disability, and reduced quality of life that follows from a serious hip fracture and subsequent admission into a nursing home4.
Combat Osteoporosis – it is preventable and treatable!
It is often difficult to get a bone density scan or treatment for osteoporosis4, even if you have already had a fragility fracture5(!) and it can be expensive to pay for a private appointment. I can offer you the chance to have your bone density checked, either by participating in – or hosting – a bone density awareness and testing day. I offer a heel quantitative ultrasound scan (or QUS), which has been shown to be a reliable indicator of bone density and fracture risk12-49 – in particular, of hip fracture risk27, 28,30,34,47.. QUS is comparatively reasonably priced, and free from radiation, as it uses sound waves rather than X rays to measure bone density. This type of test has been recommended as a ‘first step’ to educate yourself about your bone health and safeguard yourself against osteoporosis1. Find out more about the type of test I offer here.
If you have a bone density test with me, I will take the time to explain exactly what your results mean to you. I’ll also give you two sets of copies of your results – one to keep, and one to give to your GP. From my perspective, one of the most important things about having a test is that screening bone density and explaining the results of the scan to the individual has been shown to be a motivator of osteoporosis preventive behaviour50-52. In other words, after having a scan with me you will be much more likely to go out and actually act upon the advice that I give – much more than if I just gave you the advice on its own or, for example, handed out leaflets at a stall or stand53. From the results of this test, and the information and advice I give out, you, and your colleagues, employees, members or even friends will be better educated and motivated to help combat this illness, giving you all a greater chance of maintaining your bone density in later life.
- Glenville, M. (2005). Osteoporosis – the silent epidemic. London: Kyle Cathie Ltd.
- Fulgoni, V.L., Huth, P.J., DiRienzo, D.B., Miller, G.D. (2004). Determination of the Optimal Number of Dairy Servings to Ensure a Low Prevalence of Inadequate Calcium Intake in Americans. Journal of the American College of Nutrition, Vol. 23, No. 6, pp651-659.
- Gorman, T. (1996). Osteoporosis, 26th June. Cited in Hansard, pp 314-315. Retrieved 4th April 2008 from: http://hansard.millbanksystems.com/commons/1996/jun/26/osteoporosis
- The National Osteoporosis Society (2007). Osteoporosis Facts and Figures. Retrieved 5th April 2008 from: http://www.nos.org.uk/dr_media/nos/Osteoporosis_Facts_and_Figures_05-Apr-08.pdf
- Siris, E.S., Miller, P.D., Barrett-Connor, E., Faulkner, K.G., Wehren, L.E., Abbott, T.A., Berger, M.L., Santora, A.C., & Sherwood, L.M. (2001). Identification and Fracture Outcomes of Undiagnosed Low Bone Mineral Density in Postmenopausal Women. Results from the National Osteoporosis Risk Assessment. JAMA, 286(22):pp. 2815-2822. Retrieved 28th September 2007 from: http://jama.ama-assn.org/cgi/reprint/286/22/2815
- World Health Organisation. Regional Office for Europe. (1990). The Health of Europe: Summary of the Second Health for All Evaluation. Geneva: WHO.
- World Health Organization (2006). Invest In Your Bones: Osteoporosis in the Workplace. International Osteoporosis Foundation.
- Nelson, M.E. (2000). Strong Women Stay Young. Cornwall: Aurum Press.
- The American Academy of Orthopaedic Surgeons (2008). Retrieved 29thFebruary 2008 from: http://orthoinfo.aaos.org/topic.cfm?topic=A00305&return_link=0
- The American Academy of Orthopedic Surgeons (2008). Retrieved 29thFebruary 2008 from: http://orthoinfo.aaos.org/topic.cfm?topic=A00417
- Cluett, J. (2007). Complications of Hip fractures. Retrieved 4th April 2008 from: http://orthopedics.about.com/cs/hipsurgery/a/brokenhip_4.htm
- Bauer, D.C. (2007). QUS predicts hip and non spine fracture in men: the MrOs study. Osteoporosis International. 18(6) pp. 771-777
- Bauer, D.C., Glüer, C.C., Cauley, J.A., Vogt, T.M., Ensrud, K.E., Genant, H.K., & Black, D.M. (1997) Bone ultrasound predicts fractures strongly and independently of densitometry in older women. Arch Intern Med, 157: pp. 629-634
- Blanckaert, F., Cortet, B., Coquerelle, P., Flipo, R.M., Duquesnoy, B., Marchandise, X., & Delcambre, B. (1997) Contribution of calcaneal ultrasonic assessment to the evaluation of postmenopausal and glucocorticoid-induced osteoporosis. Rev Rhum [Engl Ed] 64: pp. 305-313
- Cauley, J.A., Danielson, M.E., Gregg, E.W., Vogt, M.T., Zmuda, J., Bauer, D.C. (1997).Calcaneal ultrasound attenuation in older African-American and Caucasian-American women. Osteoporosis International, 7(2):pp. 100-104.
- Cook, R.B., Collins, D., Tucker, J. & Zioupos, P. (2005). The ability of Peripheral Quantitative Ultrasound to identify patients with low bone mineral density in the hip or spine. Ultrasound in medicine and biology,31 (5) pp. 619 – 624.
- Danielson, M.E., Cauley, J.A., Baker, C.E., Newman, A.B., Dorman, J.S., Towers, J.D., Kuller, L.H. (1999). Familial resemblance of bone mineral density (BMD) and calcaneal ultrasound attenuation: the BMD in mothers and daughters study. Journal of Bone Miner Res. 14(1): pp.102-110.
- Dolan, A. L., Arden, N.K., Grahame, R., & Spector, T.D. (1998). Assessment of bone in Ehlers Danlos syndrome by ultrasound and densitometry.Ann Rheum Dis, 57, pp. 630 – 633.
- Drozdzowska, B., Pluskiewicz, W. (2001). Quantitative ultrasound at the calcaneus in premenopausal women and their postmenopausal mothers.Bone, 29(1): pp.79-83.
- Freidiani, B., Acciai, C., Falsetti, P., Baldi, F., Filippou, G., Siagkri, C., Spreafico, A., Galeazzi, M., Marcolongo, R. (2006). Calcaneus ultrasonometry and dual energy X-ray absorptiometry for the evaluation of vertebral fracture risk. Calcif Tissue Int. 79(4): pp. 223-229.
- Frost, M.L., Blake, G.M., Fogelman, I. (2000). Contact quantitative ultrasound: an evaluation of precision, fracture discrimination, age-related bone loss and applicability of the WHO criteria. (1999).Osteoporosis International, 11(8):pp. 726.
- Frost, M.L., Blake, G.M., Fogelman, I. (2002). A Comparison of fracture discrimination using calcaneal quantitative ultrasound and dual X-ray absorptiometry in women with a history of fracture at sites other than the spine and hip. Calcif Tissue Int, 71(3) pp.:207-11
- Frost, M.L., Blake, G.M., Fogelman, I. (2001). Quantitative ultrasound and bone mineral density are equally strongly associated with risk factors for osteoporosis. Journal of Bone Mineral Research, 16(2): 406 – 16.
- Frost, M.L., Blake, G.M., Fogelman, I. (2001). Does the combination of quantitative ultrasound and dual energy X-ray absorptiometry improve fracture discrimination? Osteoporosis International, 12(6):pp.471-7.
- Fujiwara, S., Sone, T., Yamazaki, K., Yoshimura, N., Nakatsuka, K., Masunari, N., Fujita, S., Kushida, K., Fukunaga, M. (2005). Heel bone ultrasound predicts non-spine fracture in Japanese men and women.Osteoporosis International, 16(12), pp. 2107-2112.
- Gonnelli, S., Cepollaro, C., Gennari, L., Montagnani, A., Caffarelli, C., Merlotti, D., Rossi, S., Cadirni, A., Nuti, R. (2005). Quantitative ultrasound and dual-energy absorptiometry in the prediction of fragility fracture in men. Osteoporosis International, 16(8), pp963-968.
- Hans, D., Dargent-molina, P., Schott, A.M., Sebert, .JL., Cormier, C., Delmas, P.D., Pouilles, J.M., Breart, G., Meunier, P.J. (1996). “Ultrasonographic heel measurements to predict hip fracture in elderly women: the EPIDOS prospective study.” Lancet, 348: No. 9026, pp. 511-514
- Hans, D., Durosier, C., Kanis, J.A., Johansson, H., Schott-Pethelaz, A.M., Krieg, M.A. (2008). Assessment of the 10-year probability of osteoporotic hip fracture combining clinical risk factors and heel bone ultrasound: the EPISEM prospective cohort of 12,958 elderly women. Journal of Bone Mineral Research, 23(7) pp. 1045 – 1051.
- Hartl, F., Tyndall, A., Kraenzlin, M., Bachmeier, C., Gückel, C., Senn, U., Hans, D., Theiler, R.(2002). Discriminatory ability of quantitative ultrasound parameters and bone mineral density in a population-based sample of postmenopausal women with vertebral fractures: results of the Basel Osteoporosis Study. Journal of Bone and Mineral Research,17(2):321-30.
- He, YQ., Fan, B., Hans, D., Li, J., Wu, C.Y., Njeh, C.F., Zhao, S., Lu, Y., Tsuda-Futami, E., Fuerst, T., Genant, H.K. (2000). Assessment of a new quantitative ultrasound calcaneus measurement:precision and discrimination of hip fractures in elderly women compared with dual X-ray absorptiometry. Osteoporosis International, 11(4): pp.354-60.
- Hollaender, R., Hartl, F., Krieg, M.A., Tyndall, A., Geuckel, C., Buitrago-Tellez, C., Manghani, M.,. Kraenzlin, M., Theiler, R., and Hans, D. (2008). Prospective evaluation of risk of vertebral fractures using quantitative ultrasound measurements and bone mineral density in a population-based sample of postmenopausal women: Results of the Basel Osteoporosis Study. Ann Rheum Disease. (e-pub ahead of print)
- Huang, C., Ross, P.D., Yates, A.J., Walker, R.E., Imose, K., Emi, K, Wasnich, R.D. (1998). “Prediction of fracture risk by radiographic absorptiometry and quantitative ultrasound: a prospective study.” Calcif Tissue International, 63: 380-384
- Huopio, J., Kröger, H., HonKanen, R., Jurvelin, J., Saarkosi, S., Alhara, E. (2004), Calcaneal Ultrasound predicts early postmenopausal fractures as well as axial BMD. A prospective study of 422 women. Osteoporosis International, 15 (3): 190–5.
- Khaw, K., Reeve, J., Luben, R., Bingham, S., Welch, A., Wareham, N., Oakes, S., Day, N. (2004). Prediction of total and hip fracture risk in men and women by qualitative ultrasound of the calcaneus: EPIC-Norfolk prospective population study. Lancet, 363 pp. 197 – 202.11.
- Marin, F., Gonzales-Macias, J., Diez-Perez, A., Palma, S., Delgado-Rodriguez, M. (2006). Relationship Between Bone Quantitative Ultrasound and Fractures: A Meta-Analysis. Journal of Bone and Mineral Research, 21(7): pp1126-1135.
- Miller, P.D., Siris, E.S., Barrett-Connor, E, Faulkner, K.G., Wheren, L.E., Abbott, T.A., Chen, Y. T., Berger, M.L., Santora, A.C., & Sherwood, L.M. (2002). Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: Evidence from the National Osteoporosis, Risk Assessment. Joural of Bone Mineral Res.17(12):pp. 2222 – 2230
- Minnock, E., Cook, R., Collins, D., Tucker, J., Zioupos, P. (2008). Using Risk Factors and Quantitative Ultrasound to Identify Postmenopausal Caucasian Women at Risk of Osteoporosis. Journal of Clinical Densitometry. http://dx.doi.org/10.1016/j.jocd.2008.04.002
- Nairus, J., Ahmadi, S., Bakerr, S., Baran, D. (2000). Quantitative Ultrasound: An indicator of Osteoporosis in Perimenopausal Women. Journal of Clinical Densitometry, 3(2), pp. 141–147.
- Njeh, C.F., Hans, D.., Li, J., Fan, B., Fuerst, T., He, Y.Q., Tsuda-Futami E., Lu, Y., Wu C.Y., Genant, H.K. (2000). Comparison of six calcaneal quantitative ultrasound devices: precision and hip fracture discrimination. Osteoporosis International, 11(12) pp. 1051-1062.
- Peretz, A., De Maertelaer, V., Moris, M., Wouters, M., Bergmann, P. (1999). Evaluation of quantitative ultrasound and dual X-Ray absorptiometry measurements in women with and without fractures. Journal of Clinical Densitometry, 2(2): pp.127-133
- Pinheiro, M.M., Castro, C.H., Frisoli, A. Jr., Szejnfeld, V.L. (2003). Discriminatory ability of quantitative ultrasound measurements is similar to dual-energy X-ray absorptiometry in a Brazilian women population with osteoporotic fracture. Calcif Tissue Int., 73(6):555-564.
- Pluskiewicz, W., Drozdzowska, B. (1999). Ultrasonic measurement of the calcaneus in Polish normal and osteoporotic women and men. Bone, 24(6): pp. 611-617.
- Thompson, P.W., Taylor, J., Oliver, R., Fisher, A. (1998). Quantitative Ultrasound of the heel predicts wrist and osteoporosis related fractures in women age 45 – 75 years. Journal of Clinical Densitometry. 1(3): 219 – 25.
- Stewart, A., Kumar, V., Reid, D.M., (2006). Long term fracture prediction by DXA and QUS: a 10 year prospective study. Journal of bone & mineral research, 21: 413 – 418
- Stewart, A., Reid, D.M. (2000). Quantitative ultrasound or clinical risk factors – which best identifies women at risk of osteoporosis? British Journal of Radiology, 73(866) pp. 165-171.
- Stewart, A., Kumar, V., Reid, D.M. (2006). Long Term Fracture Prediction by DXA and QUS: a 10-year Prospective Study. Journal of Bone and Mineral Research, 21(3): pp. 413-418.
- Stewart, A., Reid, D.M., & Porter, R.W. (1993). Broadband ultrasound attenuation and dual energy X-ray absorptiometry in patients with hip fractures: Which technique discriminates fracture risk. Calcified Tissue International, 54(6) pp. 466 – 469.
- Varenna, M., Sinigaglia, L., Adami, S., Giannini, S., Isaia, G., Maggi, S., Filipponni, P., Di Minno, O., Maugeri, D., de Feo, D., Crepaldi, G. (2005). Association of quantitative heel ultrasound with history of osteoporotic fractures in elderly men: the ESOPO study. Osteoporosis International, 16(12): pp. 1749-1754.
- Welch, A., Camus, J, Dalzell, N.., Oakes, S., Reeve, J., Khaw, K.T. (2004). Broadband ultrasound attenuation (BUA) of the heel bone and its correlates in men and women in the EPIC-Norfolk cohort: a cross sectional population-based study. Osteoporosis International, 15(3): pp.217-225.
- Fama, T.A., Carr, P., Leib., L. (2007). Benefits of Reporting Bone Density Results Directly to Patients. American College of Rheumatology. Poster Sessions, 162/162. Retrieved 11th November 2007 from: http://www.abstractsonline.com/viewer/SearchResults.asp
- Papaioannou, A., Parkinson, W., Adachi, J., O’Connor, A., Jolly, E.E., Tugwell, P., & Bédard, M. (1998). Women’s decisions about hormone replacement therapy after education and bone densitometry. Canadian Medical Association Journal, 159 (10): 1253-1257. Retrieved 28thSeptember 2007 from: http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1229820&blobtype=pdf
- Winzenberg, T., Oldenburg, B., Frendin, S., DeWit, L., Riley, M., & Jones, G. (2006). The effect on behaviour and bone mineral density of individualized bone mineral density feedback and educational interventions in premenopausal women: a randomized controlled trial.BioMedCentral Public Health. Retrieved 28th September 2007 from: http://www.biomedcentral.com/content/pdf/1471-2458-6-12.pdf
- Hillsdon, M., Thorogood, M., White, I., & Foster, C. (2002). Advising people to take more exercise is ineffective: a randomized controlled trial of physical activity promotion in primary care. Int J Epidemiol. 31(4):808-15. Retrieved 29th September 2007 from:http://ije.oxfordjournals.org/cgi/reprint/31/4/808