Osteoporosis & Bone Diseases | Risk Factors | MedStar Health
A female patient lays in a bone densitometer scanner while undergoing testing.

Osteoporosis is a chronic bone disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and more likely to break. Osteoporosis is often called a silent disease because many people do not realize they have it until they fracture (break) a bone due to a fall or action such as bending over. These broken bones are often referred to as fragility or osteoporosis-related fractures.

  • Primary prevention is recognizing, screening, and treating those at risk before they fracture to reduce the risk of the first fracture.

  • Secondary prevention is identifying, investigating, and treating those who have already had a fracture and are at the highest risk.

Although women appear to be at greatest risk for the condition, men can develop it as well. Once the disease has been diagnosed, there are significant physical, emotional, and financial consequences.

Fractures related to the disease most commonly occur in the wrist, hip, or spine, but can occur in other bones as well. Having weak bones does not automatically mean that your bones will break, however it does mean you have a greater risk of fractures (breaks).


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Osteoporosis occurs when the body fails to form enough new bone or when too much old bone is reabsorbed by the body - or both.

Risk factors

Having had a first, or prevalent fracture is probably the single most important risk factor for future fracture. Risk of a second fracture is five-fold higher in the first year following the first fracture.

At MedStar Health, our aim is to prevent the fractures that may happen due to osteoporosis, with a special focus on high risk patients, especially those who have a known history of osteoporosis or previous fragility fracture. Knowing your risk factors is the first step in taking an active role in the prevention, early diagnosis, and treatment of weak bones. Different physical characteristics and lifestyle factors contribute to osteoporosis and fracture risk in both men and women.

Risk factors you cannot control include:

  • Being over age 50

  • Prior fracture

  • Being female

  • Menopause

  • Family history, especially history of a hip fracture in a parent

  • Low body weight/being small and thin

Risk factors you can control include:

  • Not getting enough calcium and vitamin D

  • Not eating enough fruits and vegetables

  • Getting too much sodium and caffeine

  • Having an inactive lifestyle

  • Smoking

  • Drinking too much alcohol

Some medications and diseases can also cause bone loss and increase your risk of osteoporosis and osteoporosis-related fractures.

Although risk factors may increase your likelihood of getting the condition, having them does not necessarily mean you have, or will get, the disease.


Osteoporosis usually develops slowly over several years, without any symptoms. Most people do not know they have it until they break a hip, wrist, or other bone. Once your bones are weakened, you may see signs and symptoms including:

  • Back pain (caused by a fractured or collapsed vertebra)

  • Loss of height over time

  • A stooped posture

  • A broken bone that occurs more easily than expected

As the disease progresses, symptoms may include:

  • Dull or radiating pain in the bones or muscles

  • Curvature of the spine

  • Pain in the abdomen and neck

  • Tooth loss

Even though there are treatment options available, the best medicine is prevention.

Consequences of fractures

Although osteoporosis can affect people of all ages, the problem has reached epidemic proportions with our rapidly aging population. As baby boomers enter retirement age, treating the disease is more important than ever.

According to the National Osteoporosis Foundation:

  • One of every two women and up to one in four men over 50 will have a fracture (broken bone) in their lifetime.

  • Thirty percent of patients who suffer a hip fracture die in the first year. Approximately 20% of all fracture patients die in the first year following a fracture.

  • The number of hip fractures (breaks) in the U.S.—300,000 a year—could double or triple by 2040.

  • Osteoporosis-related hip fractures cause high mortality; this depends on many factors including age and general health.

  • Research shows the death rate due to osteoporosis-related hip fractures is very high and comparable to other severe diseases, such as breast cancer and cervical cancer.

  • Hospitalizations in women 55 years of age and older due to osteoporosis-related fractures are greater than hospitalizations for heart attack, stroke, or breast cancer.

Health consequences

Fractures related to osteoporosis may lead to reduced quality of life, disability, loss of independence, and even death, as described above. In addition, the financial costs of the disease and its associated fractures are massive. The results can include:

  • Considerable pain

  • Lost workdays and disability

  • Increased healthcare costs

  • Increased need for long-term rehabilitation and nursing home care

Recent published data evaluated the fracture burden and cost of fractures in U.S. women by using a projection model. With the anticipated population aging and growth, annual fractures are projected to increase from 1.9 million to 3.2 million (68% increase), from 2018 to 2040, with total direct and indirect related costs rising from $57 billion in 2018 to over $95 billion in 2040.

With proper screening and evaluation and effective treatment before fractures occur, we can not only reduce fractures, but also improve quality of life, control costs, and also decrease mortality.


MedStar Health uses the latest technology for bone density testing and DXA screening. In addition, MedStar Georgetown University Hospital is the only center in the D.C./Baltimore/VA area with an additional technology called trabecular bone score (TBS), which provides a window into underlying bone quality.

Other bone diseases

The experienced healthcare providers on our bone health team work with patients and families, as well as with other specialists, to diagnose and treat bone disease—a multidisciplinary approach that offers patients the highest quality care.

In addition to treating osteoporosis, we treat other bone diseases, including:

Osteomalacia: This is a softening of the bones, typically caused by a deficiency of vitamin D or calcium.

Rickets: This is a disease caused by long-time vitamin D deficiency, characterized by imperfect calcification, softening, and distortion of the bones typically resulting in bow legs. It can also be the result of genetic conditions.

Our providers

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Expert endocrinology care

Getting the care you need to treat bone disease starts with one of our osteoporosis specialists.