Doctors missing osteoporosis diagnosis

Failure to test bone-facture patients for osteoporosis could mean thousands are suffering further injuries. Experts from the Australians and New Zealand Bone and Mineral Society estimate 80 per cent of people who have injuries caused by the “silent disease” are slipping through the cracks.

Osteoporosis affects 1 million Australians and causes bones to become brittle and easier to break with minor falls or knocks.

Early diagnosis is crucial in preventing what’s called the “cascade effect” in which the risk of a future fracture rises each time you break a bone: women with osteoporosis who have fractured a bone in their spine, for example, are more than four times more likely to experience another fracture within the next 12 months.

Gail Morgan, CEO of Osteoporosis Australia, says catching patients with the disease in their 50s can make a significant difference to its severity: “Beyond your early 20s you can’t actually build bone mass, but you can stop further degradation.”

Treatment for osteoporosis includes medication, exercise and even falls training to help prevent broken bones.

Along with ANZBMS and the Royal Australasian College of Physicians, Osteoporosis Australia is calling for improved processes and more education in GP clinics and hospitals to recognise those people most as risk and to increase diagnosis of the disease.

“When people break a bone, they usually go to a hospital emergency department, which will focus on fixing the break. Some hospitals have dedicated fracture-liaison nurses to manage the patient through a process, but in most cases the patient is simply advised to see their GP who may not recognise the risk for osteoporosis, ” says Ms Morgan.

Women over 50 are at a greater risk of osteoporosis than men, particularly after menopause. Other risk factors include:

• having a family history of the disease (did anyone in your close family rapidly lose height or break a bone after a minor fall?);
• low intake of calcium and vitamin D from the sun;
• medications such as corticosteroids used for asthma, arthritis and inflammatory conditions, plus antidepressants and epilepsy and some cancer drugs;
• low oestrogen levels for women and low testosterone levels for men;
• thyroid conditions;
• chronic diseases such as rheumatoid arthritis, chronic liver or kidney disease; and
• conditions of the gut including coeliac and inflammatory bowel disease.

The test for osteoporosis is a non-invasive bone density scan, which takes around 10 to 15 minutes. A Medicare rebate only applies for people with certain conditions or those over 70 years of age, and the test costs around $50.

Are you at risk of osteoporosis? Has your doctor ordered a bone density scan… or will you be demanding one tomorrow?