Sometimes a person breaks a hip first, then they fall. This happens a lot more often than we realize. When the break is just below the ball of the hip, the fracture may have come before the fall. Moreover, that Fragility Fracture may have gradually developed over days or weeks.
How is it possible that a person does not realize that the hip is gradually crumbling? We call it a Stress Fracture when a crack gradually developes. Small cracks gradually getting bigger are usually not recognized until they are completely across the bone and it breaks, causing the patient to fall. Why?
The aching pain of a stress fracture is often too gradual to distinguish from arthritis pain until the break is complete and the whole bone collapses. The best way to see this process is to watch a video of the I-35W bridge collapsing in Minneapolis on 1st August 2007. http://search.yahoo.com/search?ei=utf-8&fr=aaplw&p=i35w+collapse Tiny cracks slowly developed in the steel until one day……..THUD!
How can you detect who is at high Hip Fracture Risk? A very low DXA T-score, especially in the spine, is a good indication. But DXA often fails if the spine is already crumbling or has arthritis. A better indication is Vertebral Fracture Assessment (VFA). Looking at the spine from the side, Vertebral Compression Deformities can indicate crumbling spongy bone in the spine before the spongy bone in the hip also crumbles.
Know where you stand. Get a Complete Bone Health Evaluation. Take Control of your future.
Jay Ginther, MD
“But, I don’t want to get fat” was the constant refrain of a patient who consistantly lost weight, lost muscle mass, and fractured again. Despite urging bordering on harassment, from her friends, she avoided meats and other proteins, most vegetables, fiber, and starches. She often found room for desserts.
Her muscles were so weak that she had trouble rising from a chair. Her walk had become a slow shuffle. Her skin became tissue-paper thin. Her Body Mass Index (BMI) had fallen far into the danger zone of below 19. It is possible to be Too Thin. Persons with a BMI below 19 are at increased Fracture Risk, and increased Risk of Death From All Causes.
Today we are thankful for what we have. We take time to cherish family and friends.
We tune out the frantic dash of Black Friday Sales. We reflect on the human values that make life worth living.
We and our world are far from perfect. But we do have more material wealth than ever before. We have greater opportunity for advancement than ever before. The Pursuit of Happiness is available to all. Catching up with Happiness is as elusive as ever.
Read “The Blue Zones” and “Thrive” by Dan Buettner. (Use the link to the right.) Incorporate the traits he observed in those living longer, happier lives.
Pause. Contemplate. Realize how blessed we are compared to any time in history. Give Thanks.
Jay Ginther, MD
Wrong Question! What you should be managing is Fracture Risk. If you only look at Bone Mineral Density (BMD), you miss the chance to decrease Fracture Risk in the overwhelming majority of people.
85% of the women who Fracture have a DXA score of “osteopenia” or even “normal”. Keeping their bone density at “only osteopenia” does them no favor. So how can you manage Fracture Risk?