Osteoporosis vs. Osteoarthrit... Video Transcript

Participants

, Allan Metzger MD, Neki Mohan , Danielle Petersel MD

Summary

Osteoporosis and osteoarthritis are distinct diseases which require very different treatments. But many of their symptoms are similar, which can lead to harmful misdiagnoses. What warning signs should you look out for to recognize each disease? What can you do to make sure your diagnosis is the right one? Join us for an expert look at these two serious conditions.

Webcast Transcript

NIKI MOHAN: Dr. Metzger, what's the difference between osteoporosis and osteoarthritis?

ALLAN METZGER, MD: They are completely different diseases, but unfortunately patients don't understand that. Osteoarthritis is something that occurs with trauma or aging and it's a problem with cartilage. The cartilage degenerates and loses its ability to protect between joints and patients get arthritis or spurs or a pain syndrome.

Osteoporosis effects the bone itself, not the cartilage, and is most importantly, unfortunately, a silent disease. There is loss of the integrity and strength and power of the bone itself and most patients don't have symptoms until they get a fracture.

NIKI MOHAN: How can an osteoporotic spinal fracture feel similar to arthritis, or does it?

ALLAN METZGER, MD: It may rarely if you have an older woman, for example, who has osteoarthritis in the spine. On top of it, she may get a fracture because of osteoporosis, and low back pain may come on gradually andmay feel like osteoarthritis. Most of the time when you have a fracture, you know it. It's an acute, severe debilitating sudden illness, episode, whereas osteoarthritis is often more gradual, even though it may be in the same population or the same low back location.

NIKI MOHAN: How common is it for patients to confuse the two and do they often?

ALLAN METZGER, MD: Patients confuse it because they have a sense that osteoporosis gives them pain. In general, patients confuse it and unfortunately once in a while physicians are not aware enough about osteoporosis to put that in a differential diagnosis of how they approach the patient.

NIKI MOHAN: Now what if someone comes in the office and they say, "My back's hurting. I've had this back pain here." How does that feel different from osteoporotic pain?

ALLAN METZGER, MD: It generally does. If someone comes in with a back pain, for example, a woman who's 40, who's still having her periods, 99 percent of the time it will not be osteoporosis or a fracture because theoretically they still have estrogen and theoretically they don't have osteoporosis unless they haveother risk factors.

Women who are, say in their 70's, who have not been on estrogen, who present with sudden terrible back pain, I'm always concerned about a disk or a fracture.

NIKI MOHAN: What are those risk factors? Let's run through them.

ALLAN METZGER, MD: The important risk factors are related to genetics. We know there is a high risk in families. If a mother has osteoporosis and/or a fracture, there is a higher risk for the daughter or even the son. Other risk factors are clearly related to menopause -- early menopause or late onset of periods --so estrogen deficiency is a risk factor.

Another risk factor could be different medicines. If you're given too much cortisone or too much thyroid replacement, accidentally by your physician, that can affect the bones.

Lifestyle issues are also critical. If you don't exercise, if you're so to speak a couch potato, we know that that's not good for the bones. If you're exercising moderately, that's good. But we've also learned that too much exercise -- somebody who is a weekend warrior every day of the week and loses body fat and loses body muscle and loses body weight --that person, who has a relative loss of her periods, sometimes is at risk.

People who don't have enough calcium in their diet or don't take supplemental calcium or don't drink milk, can have a risk factor.

NIKI MOHAN: Let's talk about the age at which osteoporosis becomes a threat.