Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Osteoporosis (or porous bone) is a disease in which bones become weak and are more likely to break. Without prevention or treatment, osteoporosis can progress without pain or symptoms until a bone breaks (fractures).
Fractures commonly occur in the hip, spine, and wrist.
Osteoporosis is the underlying cause of more than 1.5 million fractures annually (300,000 hip fractures, approximately 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures in other areas).
The estimated national cost (hospitals and nursing homes) for osteoporosis and related injuries is $14 billion each year in the United States.
Osteoporosis is not just an "old woman's disease." Although it is more common in white or Asian women older than 50 years
of age, osteoporosis can occur in almost any person at any age. In fact, more than 2 million American men have osteoporosis, and in women, bone loss can begin as early as 25 years
of age. Building strong bones and reaching peak bone density (maximum strength and solidness), especially before the age of 30, can be the best defense against developing osteoporosis. Also, a healthy lifestyle can keep bones strong, especially for people older than 30 years
Osteoporosis is more or less preventable for most people. Prevention is very important because, while treatments for osteoporosis are in place, currently no cure exists. Prevention of osteoporosis involves several aspects, including nutrition, exercise, lifestyle, and, most importantly, early screening with bone density tests.
The Importance of Screening for Osteoporosis
Early detection of low bone mass (osteopenia) or osteoporosis is the most important step for prevention and treatment. If osteopenia or osteoporosis has occurred, a person can take action to stop the progression of bone loss. Remember, effective treatment or prevention cannot take place if a person does not know he or she has, or is at risk for, osteoporosis.
The only way to accurately test the strength and solidness of the bones is with bone mineral density (BMD) tests. Bone mineral density tests measure the solidness and mass (bone density) in the spine, hip, and/or wrist, which are the most common sites of fractures due to osteoporosis. Other tests measure bone density in the heel or hand. These tests are performed like
X-rays. They are painless, noninvasive, and safe. The risk of radiation is very minimal, much less than even having a chest
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A bone mineral density (BMD) scan is usually done in the special radiology department or clinic by a technologist. Peripheral dual-energy X-ray absorptiometry (P-DEXA) machines are portable units that can be used in a doctor's office.
You will need to lie on your back on a padded table. You can usually leave your clothes on. You may need to lie with your legs straight or with your lower legs resting on a platform built into the table.
The machine will scan your bones and measure the amount of radiation they absorb. The DEXA technique, which scans the hip and lower spine, takes about 20 minutes to perform. Other techniques may take 30 to 45 minutes.
Portable machines (P-DEXA) can measure bone density in the wrist or forearm.
Testing at least two different bones (preferably the hip and spine) each time is the most reliable way of measuring BMD. It is best to test the same bones and to use the same measurement technique and BMD equipment each time.
Osteoporosis is a systemic skeletal disease characterized by low bone mass and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to bone fracture.