Screening for Osteoporosis

Q:  I've recently read that women should be screened for the presence of osteoporosis. Who should be screened, and what should be done with the information?

A:  Osteoporosis affects 24 million Americans, 33 percent of whom are post-menopausal women. Each year, there are 250,000 to 300,000 hip fractures costing health care systems $8 billion to $10 billion. The human costs are even higher, as a hip fracture often begins a cascade of events leading to disability and occasionally death.

Our bones are living tissues undergoing constant remodeling. They are composed of structural or trabecular bone and surface or cortical bone. Osteoporosis occurs when the destruction of bone is not countered by the generation of new bone - a phenomenon that takes place in women at an accelerated rate after menopause and occurs more slowly but as well in aged men.

Screening should be considered for those who:

• Have a history of a prior fracture of the hip or vertebrae
• Have a positive family history of osteoporosis
• Have an insufficient calcium intake
• Have used steroid-containing medications
• Have a low body weight or a history of an eating disorder
• Are smokers

Screening may involve an ultrasound test of the heel or a bone density measurement taken form the wrist, finger or forearm. Regular X-rays are not sensitive enough and, as a result, are not reliable. Any positive screen should be followed by a bone density study that looks at the spine and hip.

Be careful to have the screen done by a doctor or hospital you are familiar with, as this has become a business venture for some now that Medicare will pay for the screening process.

"Your Health" provides easy-to-understand information about common health conditions.