How to recognize a disease-related fracture?
- The primary cause of osteoporosis is aging.
- Women are more frequently affected than men by osteoporosis, especially after menopause.
“Fractures related to osteoporosis occur under conditions equivalent to a fall from height, this is the definition that we retain, explains Pr Karine Briot, Rheumatologist. The important point is that it should not be considered normal to fracture after a fall. (…) You have to ask yourself the question of osteoporosis (…). Any fracture that occurs, linked to a fall from its height, whether on ice or with special conditions, must lead to the question of osteoporosis being raised and therefore to carrying out a bone densitometry. [un examen qui permet de mesurer la densité osseuse et d’établir le diagnostic d’ostéoporose]”.
The first fracture often screens for osteoporosis
According to‘Health Insurancethis A bone disease, osteoporosis, is characterized by a decrease in bone density and mass. When a person is affected, their bones are therefore more fragile, less resistant, and the risk of fractures increases. The most common are vertebral, femoral neck or wrist fractures.
Before a first fracture, osteoporosis often has no clinical signs and is not painful. A patient can thus discover a fractured vertebra during an X-ray, without ever having been in pain. But whether it is painful or not, it is always a sign of bone fragility.
Only fractures of the skull, face, fingers, toes and part of the column which are the cervical vertebrae are not considered as osteoporotic fractures. “It is necessary to identify the patients who have had a first bone fragility fracture to ask the question of a drug to prevent other fractures”, says Professor Karine Briot. Indeed, if a first fracture is not followed up, there is a greater risk of having others.
Identify patients most at risk for osteoporosis
And all the more so since there is currently no way to diagnose this disease upstream, except when there is a fracture or low bone density. To know which patients are most at risk, doctors generally rely on height loss.
“Today, since we can’t do spine x-rays for everyone, we use height monitoring, continues Professor Karine Briot. It is necessary to measure the patients and the patients regularly and as soon as one finds in the follow-up a loss of height around two centimeters, it is perhaps the sign of a fracture of vertebrae which has gone unnoticed. If there is no repeated height measurement, the patient is asked about his height at age 20. If a difference of more than four centimeters is discovered, it is a good indication for X-rays.”.
In 2013, in France, 177,000 people over 50 (including 2/3 over 70) were hospitalized for an osteoporotic fracture, according to Health Insurance. These hospitalizations concerned three women for one man because this disease affects more patients: approximately 39% of women aged 65 suffer from osteoporosis and, among those aged 80 and over, this proportion rises to 70%.
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