In the past year, I have seen several people present with hip fractures. This is an injury that in some cases can be avoidable, which would save a lot of pain and suffering.
It is simple enough to screen for osteoporosis, or its precursor, osteopenia. It requires a special set of x-rays called a DEXA scan. This yields a set of numbers called a T-score and a Z-score. The T score compares your bone density to a younger person's, and a Z-score is age adjusted. A normal T-score is from 0 to -1.
Until recently, the evidence only supported treating people with a T score of less than -2.5. However, recently there has been unveiled a calculator that can predict the risk of serious fracture, which helps us determine which patients with a T-score from -1 to -2.5 would also benefit from medical treatment. This is called the FRAX calculator, and you can find the link below:
Those with a 10 year risk of hip fracture greater than 3% should consider treatment, as they are considered at higher risk for fracture.
Prevention of osteoporosis involves weight bearing exercise and calcium/vitamin D supplementation. The weight bearing exercise component puts small amounts of stress on bones and stimulates them to increase their density. The calcium and vitamin D make sure that your body has the building blocks it needs to stabilize and strengthen your bones.
Their are many options for treatment currently available for osteoporosis and those with osteopenia that are considered at high risk. They include:
Bisphosphonates (such as Fosamax, which is now available generically)
most of these are taken orally, but IV forms are available (Reclast and Boniva)
For women, hormone therapy or SERM (selective estrogen receptor modulators)
Forteo (a parathyroid hormone analogue)
Prolia ( a human antibody that is given via injection)
If you are over 65, or take medicines such as steroids, antiseizure medications, thyroid supplements, ask your doctor whether you should be screened.