When should we worry about osteoporosis ?

Andreus/epictura

Published the 20.10.2017 at 07h40

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Keywords :

OstéoporoseDensitométrie osseuseprévention

When a suspicion for osteoporosis ?

Prior to the occurrence of fracture, the diagnosis of osteoporosis can be suspected in case of :

• Loss of height (more than 3 cm compared to the size at 20 years = that which appears on the identity card),
• Pronounced curvature toward the front of the dorsal spine (” kyphosis ” exaggerated),
• Unexplained pain and non-specific to the spine,
• Family history of fracture,
• Early menopause (before 45 years),
• Diseases of the thyroid, parathyroid, pituitary, and adrenal glands
• Renal colic (with notion of calculation ” radio-opaque “),
• Taking cortisone, anti-epileptic drug or hormone medications sexual (in some cancers).

Some fractures, so-called ” alert “, occur before the fracture the more severe and can also be a sign of alarm : fractures of the wrist or a rib after menopause, spontaneously or to minimal trauma or moderate (drop height, false movement, etc.).

Who is at risk of osteoporosis ?

Osteoporosis is a disease of the bones of the skeleton, which is admittedly most common during the aging and after the menopause, but that is also secondary to certain diseases, and in this case, occurs earlier in the course of life. It affects both men and women, but these are concerned earlier because of the deficiency of brutal sex hormone in the fifties, when menopause.

The main circumstances that promote it depend on the type of osteoporosis :
• In the course of osteoporosis primitives, the first risk factor is age (age greater than 60 years), followed by the deficit in sex hormones (after menopause), family history of fractures in the immediate family (mother, sisters, father) and some rare inherited diseases such as osteogenesis imperfecta (or disease Lobstein), or genetic abnormality like Turner syndrome.
• Osteoporosis secondary are osteoporosis in relation to an acquired illness or taking a medication. They are represented by :
– An early menopause (before 45 years), who exhibited a deficit in sex hormones,
– A prolonged interruption of the menses (secondary amenorrhea, such as in anorexia nervosa),
– Corticosteroids at high dose for a period of at least three months,
– Taking certain anti-epileptic, anti-estrogen (anti-aromatase, analogues of LH-RH) or anti-androgens,
– A disease of the thyroid gland (hyperthyroidism), parathyroid (hyperparathyroidism), pituitary gland (adenoma and pan-hypopituitarism or failure gonadotrope), adrenal (Cushing’s disease), the ovaries or testes (gonadal failure),
– A slimming excessive body mass index (BMI) less than 19),
– Anorexia nervosa, malnutrition, intestinal malabsorption, for example, a gluten intolerance) or undernutrition,
– A form of inflammatory rheumatism such as rheumatoid arthritis, ankylosing spondylitis,
– An inflammatory disease of the colon and the intestine (Crohn’s disease or ulcerative colitis) with malabsorption or gluten intolerance if not treated,
– Intoxication alcohol-smoking with severe involvement of the liver,
– Chronic leakage of calcium in the urine (with or without kidney stones) or chronic renal failure, severe,
– An organ transplant (heart-lung, liver, kidney),
– A deficiency of vitamin D (in particular through the lack of daylight in the winter or in the elderly with reduced mobility),
– Physical inactivity or prolonged immobilization (or flights the spatial weightless),

The risk of osteoporosis is even more marked that the factors which are associated with it.

In practice

The French Society of Rheumatology offers women over fifty years of age a questionnaire very simple to find out if it is necessary to seek a osteoporosis :

In the event of a positive response to any of these questions, it is strongly recommended to perform a bone densitometry.