Friday, June 15, 2012

Osteoporosis Bone Fragility Clinic “Own The Bone”

St. Peters Bone and Joint in junction with Dr. Paul M. Spezia, D.O. is entering a new and exciting phase of holistic treatment of our orthopedic patients.  We are now actively screening for devastating osteoporosis as well as teaching its prevention and treating for its cure at St. Peters Bone and Joint.

Osteopenia and the associated fractures that come with it have become epidemic in proportion in America.  Thirty-four million people have osteopenia and are at increased risk for osteoporosis.  Each year in the United States 1.5 million osteoporotic fractures occur.  Of these, 700,000 occur in the spine, 300,000 occur in the hip, and 200,000 occur in the wrist.  One in two women and one in three men greater than 50 years of age will have an osteoporotic fracture. 

The United States Surgeon General’s 2004 report noted that 325,000 patients sustained hip fractures each year.

  • 25% enter a nursing home.
  • 50% will not regain previous functional level.
  • 25% die in the first year.

There are risk factors that are modifiable to include:

  • Tobacco.
  • BMI less than 20 in women, less than 25 in men.
  • Low calcium intake.
  • Low vitamin D intake.
  • Excessive alcohol.
  • Recurrent falls.
  • Poor physical activity.
  • Poor physical health.
  • Estrogen deficiency.

Nonmodifiable factors:

  • Genetics.
  • History of a fragility fracture in a first-degree relative. 
  • Fragility fractures are those fractures of the spine, hip, wrist, and shoulder that result from low impact trauma such as a fall from a standing height.
  • Female.
  • Advanced age
  • Caucasian.

We will utilize sophisticated tools to evaluate your relative risk for developing a fracture based upon your history and DEXA scan which we will obtain as well to determine the risk of an osteoporotic fracture in the next 10 years.  Screening will include both laboratory screening to determine metabolic abnormalities or deficiencies to include serum calcium, serum phosphatase, serum alkaline phosphate, albumin, 25 hydroxy vitamin D level, and TSH.  We will obtain a DEXA scan.  This is a low dose radiation scan with only 1 to 3 millirem, which is the equivalent of a cross-country flight.  With your history and DEXA scan, this will guide our treatment of your bone health so that we can hopefully prevent future painful fractures.  After your DEXA scan is obtained, a T score will be awarded to you.  This scores the patient’s bone mineral density relative to population to time of peak bone mass age 25 to 30. 

  • T score lower than a -2.5 is consistent with osteoporosis and at risk for fragility fracture. 
  • T score between -1 to -2.4 is consistent with osteopenia, which is a precursor to osteoporosis.

Treatment medications will be recommended as well as be offered to start you on your path to bone health.

This will be done in conjunction with the knowledge of both your primary care physician and involving a Board Certified Endocrinologist when this is deemed appropriate.

We are excited to be the only orthopedic practice in the St. Charles County area that provides this service of holistic health for the patient and to truly embrace prevention and seek a cure for this devastating and silent malady of the bone.  We want you to “Own Your Bone.”
Written by Paul M. Spezia, DO