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Osteoporosis, Risk Factors, Treatment, & T Score Case Study

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Updated: Jun 14th, 2019

Osteoporosis is a disease that weakens bones and reduces the ability of a person to perform physical activities and eventually cause physical disability. The common symptoms of osteoporosis are joint pains, stooping posture, and difficulties in standing. Fracture of hip, spine, and other bones is a major characteristic of osteoporosis due to fragility of bones.

Sunyecz (2008) states that in the United States, over 10 million people who are over 50 years old suffer from osteoporosis and 1.5 million cases of osteoporotic fractures occur every year.

Women are the dominant patients with osteoporosis because they experience significant changes in hormone levels during menopause. Hence, the case study of a 60-year-old female patient reflects the prevalence of osteoporosis among women. In this view, the essay seeks to enlighten the patient regarding the diagnosis, risk factors, and treatment of osteoporosis.

When one is diagnosed with osteoporosis, it means that the bone mineral density is below a certain level. To determine bone mineral density, radiography techniques are applicable. The World Health Organization recommends the use of dual-energy X-ray absorptiometry as a gold standard because it is a sensitive and an accurate method (Licata, 2006).

Dual-energy X-ray absorptiometry compares the bone mineral density of a person to that of a young person of 30 years. A young person of 30 years old is as a standard because he/she has optimum bone mineral density, and thus reliable in determining the extent of osteoporosis among individuals Thus, bone mineral density is a parameter that is applicable in the diagnosis osteoporosis.

Dual-energy X-ray absorptiometry measures bone mineral density in terms of T-score. Essentially, T-score is a scale that shows variations in bone mineral densities of individuals in terms of standard deviations against the standard reference mean. This means that the T-score values are standard deviations of bone mineral densities.

Low T-scores (standard deviations) are normal, while high T-scores are abnormal as they indicate the extent of osteoporosis. According to the World Health Organization, T-scores of zero to -0.99 show normal bone density, -1 to -2.49 shows osteopenia, above 2.5 indicates osteoporosis, and above 2.5 coupled with osteoporotic fractures is severe osteoporosis (Licata, 2006). Thus, the diagnosis of osteoporosis in the case study means that the patient has T-score of above 2.5 without any fractures.

One of the risk factors that predispose women to osteoporosis is age. Rizzoli, Bonjour, and Ferrari (2001) argue that age-related decline in bone density occurs because the rate bone resorption is slower than bone formation. Hence, at the age of 65 years, bone mineral density of the women in the case study is significantly lower than when she was at the age of 30 years.

Hormonal changes among women during menopause hasten bone loss. The rapid decline in estrogen levels after menopause is the major cause of osteoporosis among women (Rizzoli, Bonjour, & Ferrari, 2001). Hence, in this case study, the woman with the age of 60 years has low levels of estrogen, which predisposes her to osteoporosis.

The treatment of age-related osteoporosis requires supplementation of calcium and vitamin D. According to McLaughlin, Sleeper, McNatty, and Raehl (2006), supplementation of calcium and vitamin D enhances bone formation, and thus increase bone density. Hormone therapy is also essential in promoting absorption of calcium in the body.

Estrogen and calcitonin are two hormones that regulate the absorption and metabolism of calcium in the body (McLaughlin, Sleeper, McNatty, & Raehl, 2006). Both calcitonin and estrogen decrease activity of osteoclasts in bones, and consequently decrease bone resorption.

References

Licata, A. (2006). Diagnosing Primary Osteoporosis: It is More than a T-Score. Cleveland Clinic Journal of Medicine, 73(5), 473-476.

McLaughlin, E., Sleeper, R., McNatty, D., & Raehl, C. (2006). Management of Age-Related Osteoporosis and Prevention of Associated Fractures. Therapeutics and Clinical Risk Management, 2(3), 281-295.

Rizzoli, R., Bonjour, J., & Ferrari, S. (2001). Osteoporosis, Genetics, and Hormones Journal of Molecular Endocrinology, 26(1), 79-94.

Sunyecz, J. (2008). The Use of Calcium and Vitamin D in the Management of Osteoporosis. Therapeutics and Clinical Risk Management, 4(4), 827-836.

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