Osteoporosis produces no symptoms and the disease is very difficult to detect before a fracture occurs. However, once that first fracture does occur treatment remains especially important and valuable, since the rate of clinically serious fractures of the hip and spine increases as much as 20-fold after the first fragility fracture.
In this study, Ernest Hajcsar and colleagues surveyed 228 patients who had presented to Ontario fracture clinics with fractures associated with bone fragility. The authors sought to determine whether the patients had been treated for osteoporosis. Of the 108 eligible patients who responded, only 20 (18.5%) had received a diagnosis of osteoporosis either before or within 1 year of the fracture and 43 (39.8%) had experienced previous fractures. Of the 20 who received a diagnosis of osteoporosis, 8 (40%) were taking hormone replacement therapy and 8 (40%) were taking bisphosphonates; the corresponding numbers among those undiagnosed were 4 (4.5%) and 0.
The authors report that since so few patients had received a proper diagnosis, and fewer still were receiving appropriate therapy, these findings represent an “important lost opportunity to build bone mass and reduce fracture risk in a large patient population.” The study is considered important because of the demographic bulge created by Canada’s baby boomers, in whom osteoporosis will represent a serious problem.
Investigation and treatment of osteoporosis in patients with fragility fractures — E.E. Hajcsar et al
Contact: Dr. Earl Bogoch is a Professor in the Department of Surgery, St. Michael’s Hospital, University of Toronto
Journal
Canadian Medical Association Journal