Orthopaedics & Sports Medicine

Osteoporosis is a bone condition that initially presents without symptoms but increases the risk of fractures over time. It is characterised by reduced bone mineral density (BMD) and disruption of bone microarchitecture. 

In Hong Kong, as the population ages, osteoporosis is becoming a significant public health concern. Recent research indicates that over 30% of women aged 50 and above are affected, with the prevalence rising to over 40% in those aged 70 and above. 

While osteoporosis itself may not cause discomfort, its primary complication – fracture – can be serious. Among osteoporotic fractures, hip fractures are the most severe. Approximately 10% of patients with hip fractures die within one year of the injury.

1. Myth: Osteoporosis is associated with bone pain and joint pain. 
   Fact: There is no significant bone pain even in severe osteoporosis, unless a fracture occurs. In elderly women, both osteoporosis (a bone problem) and osteoarthritis (a joint problem) are common and are therefore easily confused. However, the two conditions are different, and each has its own treatment.
2. Myth: Osteoporosis can be diagnosed using ordinary X-rays 
   Fact: Unless osteoporosis reaches a very late stage, the affected bone can appear perfectly normal in an X-ray. The global standard for diagnosing osteoporosis is DEXA (Dual energy X-ray absorptiometry), which is accurate, safe and involves very low dose of radiation, making it generally recommended for menopausal women.
3. Myth: Osteoporosis only affects elderly women. 
   Fact: While osteoporosis does affect elderly women, it can affects anyone (men and women) at any age, e.g. patients with a chronic illness such as rheumatoid arthritis or chronic renal failure.
4. Myth: Osteoporosis can be successfully treated by calcium alone 
   Fact: Treatment of osteoporosis involves taking adequate amounts of calcium for absorption and other measures to prevent bone loss. While oral intake of calcium is important, it cannot guarantee enough absorption. We now know that adequate intakes of Vitamin D, especially through exposure of the skin to sunlight, and exercise are essential to improve calcium absorption. There are also drugs to reduce bone loss, e.g. bisphosphonates