Osteoporosis vs. Osteoarthrit... Video Transcript

Webcast Transcript

Now you talk a lot about the aging process. What about young people? Are young people at risk also?

ALLAN METZGER, MD: Young people are at risk. They generally have what we call secondary osteoporosis or osteopenia -- thin bones, but not in the realm of fracture. This is generally related to lifestyle issues. Anorexia, bulimia, too much exercise with the loss of periods, being on cortisone or too much thyroid hormone, or not having calcium in the diet.

Once in a while we see young people who smoke or drink too much, whether it be alcohol or caffeine. These can be risk factor issues in younger people as well.

As the population ages, men and women, the disease starts occurring with a certain frequency. Women get this illness in their 60's and 70's, men often 10 years later. And the frequency is about five to one. Many, many more women get this illness than men.

NIKI MOHAN: What about caffeine consumption? A lot of people have one, two, maybe three cups of coffee in the morning.

ALLAN METZGER, MD: We have the sense that overt caffeine ingestion, too much caffeine, multiple cups of something a day does not do well with bone formation. A little bit of caffeine is probably okay.

NIKI MOHAN: What about race? Now white women and Asian women?

ALLAN METZGER, MD: Yes. White women andAsian women have the greatest problem with osteoporosis. We have a sense that this is not lifestyle but it's genetics -- certain genetic markers that have not been defined yet. Certain parts of the gene, even though we've mapped most of the human genome, we haven't localized the defect -- why Caucasians have a greater risk than black women or intermediate risk like American Indians?

NIKI MOHAN: What kind of tests do you use to detect osteoporosis?

ALLAN METZGER, MD: The most important test is a thing called a DEXA or a QCT, a specific measurement of the mass or density of bone, a bone density test. And most physicians, hospitals, and X-ray units use what's called a DEXA (D-E-X-A). This specifically measures the boney architecture mass and exactly how much calcium is in a very solid or strong bone. An X-ray is a little inefficient.

If you see osteoporosis on an X-ray as an incidental finding, say in a yearly chest X-ray, in a 60-year-old woman, this may be related to the loss of at least 40% of calcium in the bone. You need that much loss to detect it on an X-ray.

NIKI MOHAN: How long does this take and does it hurt?

ALLAN METZGER, MD: The DEXA is probably the best test you can have and recommend. The patient doesn't get undressed. There's no embarrassment. There's no stigma to getting the test. It's painless. It takes five minutes on some of the newer machines. The nice advantage is you can measure different body parts. You can measure the spine and the hips which are the most important areas for fracture and it gives you a risk-relationship to how low the density is and kind of points us in the direction of what we need to do to help the patient.

NIKI MOHAN: Thank you very much Dr. Metzger.

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