Skeletal Disorder: Osteoporosis

Osteoporosis is a progressive bone disease that is characterized by structural deterioration of bone tissue and reduced bone mineral density(BMD). Consequences include increased pain, increased risk of fracture, loss of mobility, and death (Osteoporosis Canada 2014).

“Thirty-five year old Donna Duckworth is learning how to care for her newborn of five weeks, when she bends over the baby’s crib and feels something give in her back. The next day and the following week, the pain becomes unbearable in her back. She is breast-feeding and does not want to take any medication so she lives with the intense and continuing pain. Within a few weeks, she can no longer stand it so she goes to see her physician who orders blood work, does a complete physical and as a result, sends her to see an orthopedist who x-rays and does a bone density study. The diagnosis comes back as osteoporosis and it is found she has fractured three of her lumbar and four of her cervical vertebra.”

Osteoporosis is a detrimental bone condition, the tissue in the bones deteriorate and thus the bones become progressively brittle which presents a risk for rupture. Osteoporosis impacts more than 44 million Americans and is linked to a suggested 2 million bone fractures each year. According to the National Osteoporosis Foundation, the amount of fissures due to osteoporosis may escalate above 3 million by the year 2025. Osteoporosis is typically undetected and advances with slight warning signs until a fissure ensues. Effects of osteoporosis encompass height reduction and a curved upper back, anyone can have osteoporosis, however it is prevalent in elderly women and many may break a bone due to this condition. Recovery and prevention are vital in combating osteoporosis, though it may never be eradicated one can take measures to stabilize bone density and gain strength.

Osteoporosis, meaning porous bone from the Greek language, is bone disease that gradually and steadily wears down bone tissue and its living cells. This wearing down will eventually cause the cells of bone tissue to degrade and die, leaving their “scaffolding” to be the only things only bone together. Without living cells to take up a home in this scaffolding, minor injuries such as falls, bumping into objects, and pressure that would normally be completely and would not pose any threat to bone tissue suddenly becomes a real hazard that can easily pose a threat to one’s well-being. Osteoporosis affects a person skeletal system.

As generally stated in the introduction, osteoporosis is a skeletal disorder that involves the strength and integrity of one’s bones. The WHO defines osteoporosis as, “a systemic skeletal disorder characterized by low-bone mass, deterioration of bone tissue, increased bone fragility, and its susceptibly to recurrent fractures.” 2 The most important factor to take into account when addressing osteoporosis is the mass of bone, also referred to as, bone mineral density (BMD). As bone mass begins to decline, typically in the older population, specifically postmenopausal women, individuals are at an increased risk for fractures.3 As a result of this serious condition, many people are affected by morbidity, mortality, and economic difficulty.1

Osteoporosis is a degenerative disease of the bones generally brought on by the process of aging, unfortunately there can also be a number of underlying or secondary causes; however, preventative care and drug treatments can minimize the severity of this prevalent disease. Osteoporosis has been estimated to affect more than 200 million people worldwide (Bethel, 2015). According to the National Osteoporosis Foundation, 9.9 million Americans have osteoporosis and an additional 43.1 million have low bone density.

Osteoporosis is an age related disorder, more common in females compared to males. Osteoporosis is defined as a “skeletal disorder characterized by compromised bone strength predisposing to increased risk of fractures (Manolagaas, 2014). Osteoporosis is defined as “a disease characterized by low bone mass and deterioration of bone tissue (What is osteoporosis?2014). Osteoporosis is sometimes also referred as “silent thief” as the bone loss occurs very slowly and silently without any symptoms (Osteoporosis facts & statistics.2014). The most common site for fracture due to osteoporosis is hip followed by humerus (Woltman & den Hoed, 2010) . Osteoporosis can occur at any age, although it is a disorder common in females (especially post-menopausal females). Everyone is prone to osteoporosis (Osteoporosis facts & statistics.2014). According to Osteoporosis Canada, 1 in 3 Canadian females and 1 in 5 Canadian males may suffer fractures due to osteoporosis during their lifetime (Osteoporosis facts & statistics.2014). Canadian health care system spends 1.2 billion dollars for the acute hospitalization caused by osteoporosis and in 2010 the health care system spent 3.9 billion dollars for the total treatment of osteoporosis (Osteoporosis facts & statistics.2014). Osteoporosis can be screened and diagnosed by various methods; however the dual energy x ray absorptiometry (DXA) is commonly used. If the T-score values are less than -1 and greater than -2.5SD it is termed as osteopenia,

The body can synthesize vitamin D with the help of sunlight, from a precursor that the body makes from cholesterol. Osteoporosis is, " any failure to synthesize adequate vitamin D or obtain enough from foods sets the stage for a loss of calcium from the bones, which can result in fractures" (Whitney & Rolfes, 2013, p. 349). There are several common risk factors for developing osteoporosis, which lead to the condition of reduced bone density.

Osteoporosis is a major public heath treat for more than 28 million Americans, 80 percent of whom are women. In the U.S. today, 10 million individuals

Osteoporosis is a disease of bone that leads to an increased risk of fracture. In osteoporosis the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old healthy female average) as measured by DXA; the term "established osteoporosis" includes the presence of a fragility fracture.[1] Osteoporosis is most common in women after menopause, when it is called postmenopausal osteoporosis, but may also develop in men, and may occur in anyone in the presence of particular hormonal

Osteoporosis is a disease that is continuing to increase in numbers; as a result, the cost of care for individuals with the disease is also increasing. In 2005, seventeen billion dollars were spent to care for osteoporosis injuries. It is projected by 2050 that individuals over sixty-five years of age will increase from thirty-two million to sixty-nine million in the United States (AACE, 2010). Therefore more individuals will develop osteoporosis with age. From 2005 to 2025, with increasing age, estimated costs are expected to rise from seventeen billion dollars to twenty-five billion dollars (AACE, 2010). With outstanding projected figures, efforts to reverse the economical stance are focused on screenings, prevention, diagnosing,

Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue that increases bone fragility and risk of fractures. Osteoporosis becomes apparent with a fracture, typically the wrist, spinal or hip fractures. In Asian countries, osteoporosis is found to be a major concern in the older populations. Hip fractures in Asian countries have increased 2- to 3- fold and Taiwan was the first Asian country. According to epidemic statistics, 19.8% of women over 65 years of age have had one or more fractures. In Taiwan, the National Health Insurance spends about 40 million US dollars due to complications on the treatment for osteoporosis. This study investigated the cut off points of osteoporosis based on the OST, age, weight and BMI of premenopausal females in Taiwan and was approved by the Institutional Review Board of National Taiwan University in 2012. In 2009-2011. 11,255 Taiwanese women were put into a data base. These women were transferred to a health examination center of a medical center in Northern Taiwan, to see if they could qualify for a health insurance subsidy. These women received bone density, age, and weight measurements. Out of 11,255 Taiwanese women, 2,454 young adult women were chosen and ranged from the ages of 30-49 years old. Statistical analysis was performed to identify the cut-off point of vital variables on women with osteoporosis. The following variables: weight, BMI, and OST were divided into four quartiles. The results showed

It is also estimated that over 200 million people worldwide suffer from osteoporosis. In the United States and Europe alone, nearly 30% of all postmenopausal women are currently suffering from the disease. Since osteoporosis is highly associated with bone fractures, it is estimated that it causes over 8.9 million fractures worldwide each year, which results in a bone fracture every 3 seconds. It has also been shown that once a person has sustained an initial bone fracture due to osteoporosis, there is an 86% increase in probability that they will sustain an additional fracture. By 2050, projections are estimating that the worldwide incidence of hip fracture in women will increase by 240%, while it will increase by 310% in men. This will mean that the number of hip fractures due to osteoporosis will increase from 1.66 million cases in 1990 to 6.26 million cases by the year of 2050 (International Osteoporosis Foundation, 2015). The picture below shows this

United States has the highest rate in the world in cases of osteoporosis. According to The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) estimates that 10 million people (8 million women and 2 million men) in the United States have osteoporosis as of 2012” ("Osteoporosis “Lucent Books page 10). After all, 28 million Americans, 80% of them women, are affected by osteoporosis. Ten million already have the disease, and 18 million more have low bone mass and an increased risk for the disease; of the population over the age of 50 one out of two women and one out of eight men will have an osteoporosis-related fracture. According to figures provided by the NIH, “The estimated annual national expenditure on osteoporosis and related fractures (hospitals and nursing homes) is $14 billion" (“Osteoporosis” New Medical Therapies – Osteoporosis.)

Since the mid-1900, bone diseases have been diagonized using various radionuclides. In 1971 99mTc-labeled polyphosphonates was first used in bone scintigraphy [1]. Intravenous injection, followed by radiopharmaceutical adsorption happens at the bone surface within some hours. Perfusion of the bones and the of bone metabolism are the controlling factor of adsorption. As the bone seeking radiopharmaceuticals are excreted by the kidneys, and the kidneys and bladder can be seen routinely on a bone scan, the total uptake is a function of the combination of perfusion and metabolism rate and on renal function [2]. The epiphysieal plates of children or bone with mechanical sress shows high uptake. Additionally, in several pathophysiological conditions, even extraskeletal accumulation of tracer can be seen, e.g. in scars, myositis ossificans, liver metastases or tumors.10-12 On the other hand, fat patients (high absorption of radiation) and patients with renal failure show a reduced bone-to-background contrast resulting in degraded images [2].