Osteoporosis: Q&A With Angela Miller, DNP

Angie Miller, DNP specializes in osteoporosis and works side by side with providers to perform physical exams and procedures, order diagnostic and laboratory tests, and diagnose and treat common medical conditions.

What exactly is osteoporosis—how would you explain a diagnosis to a patient who has never heard of this condition?  
Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone, leading to bone fragility and an increased risk of fracture. It is considered a “silent disease” because it does not hurt, meaning that many people do not realize that they have osteoporosis until after they break a bone from a minor fall.

Is osteoporosis common?
Osteoporosis is quite common. It differs across sexes, with 1 in 2 women aged 50 or greater suffering from an osteoporotic fracture in their lifetime and 1 in 4 men over the age of 50 suffering from the same.

In 2025, it is estimated there will be 3,000,000 osteoporotic fractures—so I would definitely say that it is common.

If a patient suspects that they may have osteoporosis, what should their next steps be? Their next step should be to get a DEXA (dual-energy X-ray absorptiometry) scan and labs. A DEXA scan is an imaging test that measures bone density strength by using very low levels of X-rays to measure how dense your bones are. The results provide helpful details about a patient’s risk for osteoporosis and future fracture.

Some of the labs that may be obtained are the following: complete metabolic panel, vitamin D level, parathyroid hormone, thyroid stimulating hormone, urine for calcium, testosterone level, and bone markers.

Are there risk factors that can increase your chances of developing osteoporosis? 
There are many risk factors associated with developing osteoporosis, including sex (women are more likely to be diagnosed than men), age, prior fracture, low bone mineral density, parental history of hip fracture, low body weight, immobilization, excessive alcohol intake, tobacco smoking, glucocorticoid (steroid hormone) use, and rheumatoid arthritis.

When evaluating your risk of osteoporosis, fragility fractures or a recent fracture of a major skeletal site in adults greater than 50 years of age should be considered a warning sign of low bone mineral density or osteoporosis, and further investigation should be considered.

When diagnosed with osteoporosis, what are the patient’s next steps?
Once diagnosed, the patient should consider immediate treatment for osteoporosis. This may involve medications along with lifestyle changes such as regular weight-bearing balance exercises, avoiding tobacco use, limiting alcohol consumption, adequate calcium and vitamin D intake, and fall prevention courses/physical therapy—you want to do your best to prevent future bone fractures.

Whether you need attention for a persistent injury or require a major joint replacement, you deserve expert care that gets you back to doing what you love. With access to leading-edge technology and experience with advanced procedures, our nationally recognized orthopedic team is here to help you regain your strength, mobility, and confidence—all while staying close to home.

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