Bone Health Open Access
Bone
health is a lifelong concern. We build bone to our adult maximum called peak bone mass and begin losing bone thereafter. Two strategies to reduce the risk of fracture are to maximize peak bone mass within our genetic potential and to slow the rate of bone loss with age. Bone mass has been conveniently measured through imaging by dual energy X-ray absorptiometry (DXA). However, resistance to fracture is not only a function of the amount of bone, but also a function of the size and material properties of bone, which determine bone strength together with bone mass. More recently, we have the ability to get estimates of bone size and strength with another imaging instrument, peripheral quantitative-computed tomography or pQCT. The annual incidence of osteoporotic fracture in America approaches two million which is three times the incidence of stroke, four times the incidence of heart attacks, and nine times the incidence of breast cancer. Yet, public awareness of osteoporosis and physician referrals for DXA scans is low, partly because of the lower risk of mortality. Hip fracture does increase risk of dying, especially through pneumonia associated with immobility. However, the loss in
quality of life with associated pain and reduced mobility and growing healthcare costs deserve more attention. With the increases in age of Americans using census population projections, the incidence of osteoporosis is expected to increase by 32% to 17.2 million from 2010 to 2030 (Wright et al, 2014).
Fractures do not only occur in adults, but also in children.
Fractures in children are most prevalent during the pubertal growth spurt before bone consolidation occurs which results in a period of relatively low bone mass (Faulkner et al, 2006). Data from the Mayo Clinic suggest 55% of all children will experience at least one fracture before the age of 18 years and that the incidence has greatly increased since 1970
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