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Many spinal fractures going undiagnosed, group says

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CTV National News: Avis Favaro on the fracture link
A new study suggests that fractures linked to osteoporosis are going undiagnosed and untreated. Two-thirds of bone breaks are never detected, even on routine examinations, which can leave patients with a risk of long-term disability.

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Date: Thu. Oct. 14 2010 2:26 PM ET

A startling number of men and women over the age of 50 currently have small spinal fractures that are going undiagnosed and treated, says a new report by the International Osteoporosis Foundation.

The report says that 20 to 25 per cent of Caucasian women and men over 50 years of age have a current spinal fracture.

As well, as many as 65 per cent of spinal fractures caused by osteoporosis are going undetected, dismissed by both patients and their doctors as simple back pain or arthritis.

The report, entitled "The Breaking Spine," was written by University of California Professor Harry K. Genant and Dr. Mary Bouxsein of Harvard Medical School, and calls on health professionals to recognize the signs of these fractures in their patients.

"Doctors must look out for evidence of spinal fractures, especially in their patients over 50," says Professor Genant.

Those telltale signs include:

  • stooped back
  • loss of height
  • sudden, severe back pain

Only about 40 per cent of older women with spinal fractures visible on X-ray are tested for osteoporosis, according to the report. The figure is even lower in men: less than 20 per cent.

Many of those patients with spinal fractures are at risk of further fractures and long-term disability. That can lead to immobility, depression and even premature death, says International Osteoporosis Foundation President John A. Kanis.

In Canada, people over 50 who have suffered spinal fractures have a one in six chance of dying within five years.

Doctors expect rates of osteoporosis will double and perhaps triple by 2050, because of aging, poor diet and lifestyle.

"I do believe it is a health emergency," says Dr. Rick Adachi, a professor in the Department of Medicine at McMaster University in Hamilton who's involved in the Canadian Multicentre Osteoporosis Study.

He agrees that doctors need to do a better job of spotting the disease.

"I know if patients have lost two centimetres over a couple of years, we should be looking for a fracture," he says.

Salima Ladak-Kachra knows all too well that a spinal fracture can go undiagnosed. She was diagnosed with osteoporosis more than 10 years ago after fracturing her spine during a fall on a ceramic tile floor.

Her X-rays showed she had broken her vertebrae in four places. But they also revealed the signs of previous fractures that were still healing – fractures that Ladak-Kachra didn't know she was having, despite years of back pain.

"I was shocked. You always think osteoporosis is associated with the elderly, and here I was 25 being told ‘You have osteoporosis,'" she told CTV.

Ladak-Kachra realized later she had several risk factors for osteoporosis: she was underweight for her height, didn't eat calcium-rich dairy products, got no weight-bearing exercise and both her parents had the bone-thinning disease.

Today, Ladak-Kachra is a poster girl for osteoporosis prevention, exercising regularly and drinking plenty of milk products.

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