21st July 2023

Introduction

Osteoporosis is a disease of significantly reduced bone mineral density (BMD) that increases the risk of fractures, primarily due to old age. Secondary causes include high dose steroid use, hyperthyroidism, hyperparathyroidism, increased alcohol intake, smoking, BMI <18.5 kg/m², decreased testosterone, early menopause, kidney failure and liver failure. It is asymptomatic, with many people being diagnosed following a fragility fracture.
Fragility fractures occur secondary to low trauma events such as a fall from a standing height. Examples of these fractures include pubic rami or neck of femur fractures, vertebral fractures (see image below) (often appearing as vertebral collapse on imaging) and distal radial fractures (e.g., Smith or Colles fracture). It is important to investigate secondary causes, which include osteoporotic and non-osteoporotic causes, such as multiple myeloma, Paget’s disease, and metastatic bone cancer.

T12 osteoporotic compression fracture

Image Source: Wikimedia Commons (2016). T12compressionfracMark, Licensed under a creative commons licence. Available for free at: https://commons.wikimedia.org/wiki/File:T12compressionfracMark.png (Accessed: 2 March 2022).