Dr Kevin McCarroll is a consultant physician and geriatrician specialising in osteoporosis at St James’s Hospital, Dublin where he is a Clinical Lead of the Bone Heath Unit. He also co-runs the orthogeriatric service and is a Clinical Senior Lecturer in Medical Gerontology at Trinity College. He is a co-investigator in the Trinity, Ulster, Dept Agriculture (TUDA) study of over 5000 patients in which research on bone health and vitamin D is being conducted.
Osteoporosis is common and affects an estimated 300,000 people in Ireland. It is defined as decline in bone mass associated with a microarchitectural deterioration in bone resulting in increased risk of fragility fracture. In practise, the diagnosis can be made when the lowest T score on DXA is ≤-2.5 at any of three sites (total hip, neck of femur or lumbar spine). However, a clinical diagnosis of osteoporosis can also be made without bone mineral density (BMD) measurements in patients who have a fragility fracture of the hip or spine. Fragility fracture is one that occurs from a fall from standing height or due to trauma not normally expected to cause a fracture. Osteopenia is defined when the T score is between -1.0 to < -2.5. In premenopausal females and males aged under 50, a Z score < -2.0 indicates low bone mass which may due to osteoporosis though other causes such as osteomalacia need to be considered.
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