HED:Osteoporosis known as silent disease

By M. Scott Morris

Daily Journal

When asked to give their height, most people respond without thinking. It's an automatic answer that's been on their driver's license for years.

"Usually, they think of themselves at 5 feet, 5 inches tall, and low and behold, they'll be two inches shorter," said Dr. Mary Ellis Pace, who treats osteoporosis patients.

As people age, they can actually lose as much as 3 inches in height, Pace said.

"They may not even notice that they're getting shorter over time," she said.

One cause of such shrinking is osteoporosis, a disease that weakens the bones, making them easier to break.

"I could see how slumped I looked. I just thought it was old age," said Judy Burns, a 74-year-old resident of the Lake Piomingo area.

Rather than the ordinary effects of aging, Burns' posture was the result of osteoporosis.

"Until Dr. Pace diagnosed me three years ago, I had no idea I had osteoporosis," Burns said.

Silent disease

The disease usually isn't diagnosed until it's well entrenched.

"Osteoporosis is generally silent until the patient sustains a fracture," Pace said.

Patients have been known to fracture their wrists while trying to stop a fall. Hips, elbows, knees most of the body's joints are weakened by the disease and become prime candidates for fractures resulting from falls.

Some osteoporosis patients may develop a fracture or series of fractures of the vertebral bodies in the spine.

Vertebral bodies can get so thin and weak they can spontaneously collapse without an outside cause. The vertebral breaks can cause back pain and the "slumped" appearance Burns experienced.

"About 40 to 50 residents of our 120 residents have osteoporosis as a diagnosis," said Mike Bass, executive director of Tupelo Manor. Bass added that not all of those 40 to 50 people have osteoporosis as their primary diagnosis, but it does contribute to their need for long-term care.

Catching it early

"It's a lot like closing the barn door after the horse has already left. If you wait until osteoporosis is already present to treat it, you're probably too late to treat it," said Dr. John Gassaway, a West Point orthopedic surgeon.

Unfortunately, traditional X-rays are not accurate enough to provide an early diagnosis, Gassaway said.

"With an X-ray, we can't tell if osteoporosis is present until 30 percent of the bone is lost," Gassaway said.

At the IMA Clinic located at North Mississippi Medical Center's Women's Hospital, Pace has access to a dual energy X-ray absorptiometry scanner, which makes early diagnosis possible.

The bone scanner measures bone density of the hip and lower vertebral bodies. The procedure takes about 15 minutes and is completely painless.

"If you have osteoporosis in the hip or lower vertebral bodies, it suggests you have osteoporosis elsewhere," Pace said.

The scanner ranks patients' bone density with a control group as well as people in their own age group. It's a precise machine that detects changes in bone density as low as 1 percent, Pace said.

"The precision of the test is very important because it gauges small changes from year to year," Pace said.


About 80 percent of those affected by osteoporosis are women, and the onset of the disease generally accelerates within five years of menopause, when women's bodies no longer produce estrogen.

"If a lady's ovaries aren't putting out estrogen, then she's at risk for osteoporosis," Pace said. That includes women who've had their ovaries removed by hysterectomy.

The disease must be diagnosed before it can be treated. Toward that end, both Pace and Gassaway recommend bone scans for women who've reached menopause.

"The hope is we can reverse the osteoporotic process if we start treating it early enough," Pace said.

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