Osteoporosis is a condition characterised by loss of bone density, resulting in reduced bone strength, poor bone quality, and increased risk of fractures.

It manifests by fractures in the hip, spine, and wrist, although all bones are subject to the ravages of the disease.

The bone is a living tissue and a normal bone is composed of protein, collagen, and calcium all of which gives the bone its strength. The human body continues to form bone tissue until the age of 30 when bone mass is at its peak. After that, more bone is continually absorbed and bone density reduces thereafter until death.

An active lifestyle at a young age, especially with load-bearing exercises like running, walking and sports increase peak bone mass and therefore reducing the likelihood of osteoporosis later on in life.

Does the condition severity vary with gender?

In most women, the lack of estrogen, a natural consequence of menopause, is directly related to a decrease in bone density. For men, bone loss occurs more slowly. By the age of 65 or 70, most men and women lose bone almost at the same rate.

Are there symptoms to look out for?

Osteoporosis is often called “silent” because bone loss occurs without symptoms. People may not know that they suffer from osteoporosis until a sudden strain, bump, or fall causes a bone to break. This can result in a series of visits to the hospital, surgery, and possibly a long-term disabling condition.

How can I prevent osteoporosis?

The good news is that osteoporosis can be prevented and treated. Healthy lifestyle choices such as a balanced diet containing enough calcium, vitamin D, protein, micronutrients (for example, vitamin K, magnesium, and zinc) and sufficient exercise can help prevent further bone loss and reduce the risk of fractures. Limiting alcohol intake and not smoking is also recommended.

How is the condition diagnosed?

Regarding the diagnosis of osteoporosis, Bone Mineral Density (BMD) testing is used to diagnose osteoporosis. BMD uses a fully computerised Dual Energy X-Ray Absorptiometry (Dexa) scanning machine to screen patients for osteoporosis and enable doctors to accurately calculate the BMD while exposing the patients to minimal radiation.

Dexa machine uses x-ray technology and is specifically designed to calculate BMD and therefore gives more accurate results. The procedure is painless and takes only a few minutes and the patient receives the results immediately.

Like all other radiology procedures, the patient is referred for the test by a physician after an initial assessment. The doctor usually checks the risk factors which include age, sedentary lifestyle, small bone structure, family history of osteoporosis, smoking, and previous fracture following a low-level trauma, especially after age 50. The World Health Organisation has defined many threshold values (measurements) for osteoporosis.

The reference measurement is derived from bone density measurements in a population of healthy young adults (called a T-score). Osteoporosis is diagnosed when a person’s BMD is equal to, or more than 2.5 standard deviations in a T-score measurement.

Osteopenia (reduced bone mass of lesser severity than osteoporosis) is diagnosed when the measurement is between one and 2.5 standard deviations below the young adult reference measurement.

How is the condition managed/treated?

With the results indicating the patient’s bone density, the doctor can administer various drugs to keep the condition from deteriorating and also to improve bone mass.

Bisphosphonates are the most common medications prescribed for osteoporosis treatment. The same healthy lifestyle that prevents osteoporosis can also be beneficial in treating the disease.

Dr Oroko is a consultant orthopaedic surgeon at Aga Khan University Hospital, Nairobi