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Osteoporosis: What a Pain!

Bone Health & Radiology

Osteoporosis is no joke. Just by bending over or coughing, you can get a painful bone fracture if you have this condition. According to the National Osteoporosis Foundation, approximately 10 million Americans have osteoporosis and another 44 million have low bone density, placing them at increased risk.

Bone is living tissue that is continually being broken down and regenerated. Osteoporosis is a condition that occurs when the generation of new bone fails to keep up with the removal of old bone, causing the bone to become weak and brittle.

WHO’S AT RISK?

Risk factors for osteoporosis include aging, low body weight, low sex hormones or menopause, smoking, excessive alcohol consumption, and certain medications. Postmenopausal white and Asian women are at the highest risk and are the most commonly afflicted. Prevention and treatment of osteoporosis include calcium, vitamin D, healthy diet, exercise (especially weight bearing), and osteoporosis medications.

HOW DO YOU KNOW?

Our radiologists are uniquely qualified to both detect osteoporosis (using DEXA) and treat fractures resulting from the disease (through vertebroplasty and kyphoplasty).

To detect osteoporosis, your doctor may recommend a dual energy x-ray absorptiometry (DEXA) scan (aka a bone density scan or bone densitometry). This type of exam is an enhanced form of x-ray technology that measures bone loss. Currently, DEXA is the established medical industry standard for measuring bone density. It is brief, painless, and performed on an outpatient basis.

Bone density testing is recommended if you:

  • are a post-menopausal woman and not taking estrogen.
  • have a personal or maternal history of hip fracture or smoking.
  • are a postmenopausal woman who is tall (over 5” 7’) or thin (less than 125 lbs).
  • are a man with medical conditions associated with bone loss.
  • use medications that are known to cause bone loss.
  • have type 1 diabetes, liver disease, kidney disease, or a family history of osteoporosis.
  • have high bone turnover, which shows up in the form of excessive collagen in urine samples.
  • have a thyroid condition.
  • have experienced a fracture after mild trauma.
  • have had x-ray evidence of spinal fracture or other signs of osteoporosis.

This video explains what to expect during your DEXA exam:

If you already suffer from osteoporosis, you are more susceptible to bone fractures, most commonly in the wrist, spine, shoulder, and hip. Some fractures can heal on their own, depending on which bone is broken and how severe the break is (which a radiologist can determine from x-rays and other imaging exams). Other fractures can hurt for a while, particularly if you’ve broken a hip or a vertebra in your spine, (called a compression fracture).

COMPRESSION FRACTURES

Experiencing a compression fracture of the spine can lead to further issues, such as additional spinal fractures, permanent spinal deformity, loss of height, protrusion of the belly (as the result of a curved spine pushing the ribs down closer to the pelvis), and loss of appetite, and therefore nutrition. That is why it is very important to have them diagnosed and treated as soon as possible. Radiologists can do both of these actions. When you need further treatment, your doctor may refer you to an interventional radiologist to perform a kyphoplasty or vertebroplasty.

Both vertebroplasty and kyphoplasty involve the placement of cement into the fractured vertebra through small, minimally invasive incisions in the skin under x-ray guidance using fluoroscopy, performed by an interventional radiologist.

A vertebroplasty is often performed with the patient under twilight sedation in an x-ray suite or an operating room, while kyphoplasty is commonly done under general anesthesia in an operating room, but can sometimes be performed under local anesthesia.

Vertebroplasty involves injecting the bone with a cement mixture to fuse the fragments, strengthen the vertebra, and relieve pain. First, the skin is numbed with a local anesthetic. Then, using imaging guidance, an interventional radiologist passes a hollow needle through the skin into the vertebral body for injection of the cement mixture into the vertebra.

During a kyphoplasty, the skin is numbed and then an interventional radiologist inserts a balloon through the hollow needle into the fractured vertebra, where it is inflated to create a cavity for cement injection. The balloon is removed, and then cement is injected into the cavity created by the balloon.

LAST WORDS

Osteoporosis causes more than 8.9 million fractures annually worldwide, resulting in an osteoporotic fracture every 3 seconds. With an increasingly large aging population, bone health is more important than ever. Radiology provides low cost, minimally invasive methods to diagnose and treat bone conditions and injuries that had once caused debilitating pain and deformities. Now patients can have them treated in an afternoon and return to their normal lives almost immediately, feeling healthy and pain-free once again.

LEARN MORE

Learn more about DEXA here – http://divrad.com/imaging-procedures/bone-densitometry/

Learn more about treatments for spinal compression fractures and other minimally invasive procedures here – http://divrad.com/imaging-procedures/interventional-radiology/, and http://ircolorado.org/our-services/