Osteoporosis, the silent epidemic
Osteoporosis is also called the “silent epidemic”. The reason for this is that it has no warning symptoms and the first manifestation of undiagnosed osteoporosis is a low energy fracture. The most common osteoporotic fractures are of the wrist, vertebrae and hip. Of these, wrist fractures are usually treated conservatively, resulting in inadequate recording, while vertebral fractures, although significantly affecting mortality, may be asymptomatic and the patient may not be aware of their existence, which is only revealed after X-rays of the spine. However, it is crucial that they are properly diagnosed, since they have a huge impact on the risk assessment for consequent fractures.
Hip fractures are almost universally recorded as they require hospitalization and surgical repair. Consequently, they are the most reliable indicator of morbidity and mortality from osteoporosis. Contrary to what most patients and doctors of other specialties believe, osteoporosis kills. It may not kill directly, but complications from fractures are among the most common causes of death, with Osteoporosis as the underlying cause of death. With the economic crisis and the expected deterioration of all health indicators, poor patient compliance and medication discontinuation are already noticed and they will inevitably lead to an explosive increase in osteoporotic fractures.
A common occurrence in the osteoporosis clinic is having a couple of elderly patients coming for long-term follow-up of only the female, since osteoporosis affects one out of three females. The husband has never undergone a bone density measurement, despite the existing guidelines of the World Health Organization – WHO. Much to their surprise, after initial disbelief, the husband undergoes a DXA scan and osteoporosis is diagnosed in one out of ten males.
Orthopedics is one of the specialties involved in the diagnosis and treatment of osteoporosis. However, the Orthopedic Surgeon is the only physician with the privilege to monitor the patient BEFORE the fracture (to diagnose, monitor and treat osteoporosis), DURING the fracture treatment (whether conservative or operative) and AFTER the fracture (recovery and rehabilitation, continuation of treatment and prevention of consequent fractures).