Kewanee Hospital

Are Your Bones Healthy?  How Do You Know?

June 28, 2011

Osteoporosis occurs when a bone loses a significant portion of its structure and becomes weak and fragile.  While typically associated with the elderly, it actually starts as a teenager and is linked to many risky behaviors.

Bones are built to their maximum in our teenage years.  A person 9-18 years old needs 1300mg of calcium daily.  This is more than the 1200mg of daily calcium recommended for someone over 50.  Foods high in calcium include dairy products, broccoli, almonds and fortified cereals.  To calculate the amount of calcium from a food label, multiply the % daily amount by 10 to find the number of milligrams (mg) per serving.  

To build, repair and renew, bones need Vitamin D3 (400-800 international units daily) to properly use calcium.  Enough Vitamin D3 can be obtained by exposure to the sun for 20 minutes daily.  People at risk for not having enough Vitamin D are those who are inside all day. 

Other risks for developing osteoporosis include frequent use of steroids, smoking, excessive alcohol intake, inactivity, certain medications and, for women, a loss of estrogen with menopause (surgical or natural) or with eating disorders such as anorexia or bulimia.

In osteoporosis, bones slowly lose their structure over a period of years.  This may be first noticed as a change in height, but more often as a fracture.  A fracture may occur with as little as stepping off a curb, sneezing, bending to pick something up or a hug.  It may occur at a hip, the spine, a wrist or at any bone in the body.

Osteoporosis is painless until a bone is broken, and X-rays don’t detect osteoporosis until it is very severe.  So, how is osteoporosis detected? 

The most accurate test is a bone density since it measures how much bone structure is present compared to a standard.  It does not measure the quality of bone structure: this is a mystery that medicine has yet to solve.  It is useful for confirming a diagnosis of osteoporosis if the person has had a suspicious fracture or for detecting low bone density so that preventive steps can be taken. 

“During a bone density screening, specially designed imaging equipment uses small doses of radiation to determine the density of your bones,” stated Emily Renfroe, Director of Radiology at Kewanee Hospital.  “It is safe and painless.” 

During a bone density screening, patients lie on a table or place their arm inside a machine for four to five images to be taken.  The entire screening will take approximately 30-45 minutes.  Bone density screenings can be scheduled in Kewanee Hospital’s Radiology Department by calling 309-852-7550.

Bone density screenings help to identify Osteopenia, a condition of low bone density that is not to the degree of osteoporosis but does require preventative treatment.  Many insurances, including Medicare Part B, cover bone density screenings as often as every two years for age 65 and older, estrogen deficiency, vertebral abnormalities, steroid therapy, or primary hyperparathyroidism, and to monitor response to an FDA-approved drug therapy.

While the FDA has approved drug therapies, there is no cure for osteoporosis and there is no proven preventive measure.  It is proven that the onset of osteoporosis may be delayed and the severity diminished.  Bisphosphonate drugs, such as Actonel, Fosamax or Boniva, are probably the most commonly prescribed drug therapy.  Some bisphosphonates are available as IV (intravenous) therapy and at high IV dosing have a small but significant risk for necrosis of the jaw.  Some people cannot use oral bisphosphonates due to esophageal problems or due to inability to sit up for a time after taking the medication. 

Men and women of any color can develop osteoporosis.  One in five people with a hip fracture die within a year.  It can be costly in terms of money and health.  To prevent osteoporosis, please use the five steps to bone health: adequate amounts of calcium and vitamin D; weight bearing exercise such as walking, biking or weight lifting; no smoking; see your doctor regularly; and have a bone density as recommended.