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Dr. Huntley's
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Symptoms » Osteoporosis » Diagnosis Checklist
 
Dr. Huntley's

DIAGNOSIS CHECKLIST
for Osteoporosis

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques in his assesment of the symptom: Osteoporosis. These may include a physical examination or other medical tests. Your doctor may ask several questions when assessing your condition. It is important to remember that your consultation is a two-way process and any extra information you can share with your doctor may help them with their diagnosis.

Some of the questions your doctor may ask are listed below:

  1. What is the sex and age of the person with osteoporosis?

    Why: After the menopause, women lose calcium from their bones at a much faster rate than men due to the lowered levels of estrogen. By the age of 65, women have 3-5 times the risk of fractures than men.

  2. What is the race of the person with osteoporosis?

    Why: Asian and Northern European races are at an increased risk of osteoporosis.

  3. What age where you when you had your last menstrual period?

    Why: Early menopause at an age of less than 45 years increases the risk of osteoporosis. This includes early menopause due to removal of ovaries and/or uterus.

  4. Have you had a history of amenorrhea (absence of menstrual periods for over six months)?

    Why: e.g. due to low body weight, anorexia nervosa, hyperthyroidism, pituitary tumor - Amenorrhea increases the risk of osteoporosis due to estrogen deficiency.

  5. History of fractures, especially fractures with minimal trauma?

    Why: If the injury was minimal may suggest osteoporosis or pathological fracture due to bone tumor or bone metastases.

  6. Risks of osteoporosis?

    Why: e.g. female sex, thin build, family history, early menopause, smoking, chronic alcoholism, high caffeine intake, low calcium intake, intestinal malabsorption, physical inactivity, prolonged corticosteroid use, Cushing's syndrome, diabetes mellitus, hyperthyroidism, hyperparathyroidism, Acromegaly, chronic renal failure.

  7. Risk factors for bone metastases?

    Why: The common primary tumors include lung cancer, breast cancer, myeloma, esophageal cancer, thyroid cancer, prostate cancer, lymphoma and renal cell cancer. Bone metastases may need to be excluded as an alternative or additional diagnosis to osteoporosis.

  8. Past medical history?

    Why: Many medical conditions may increase the risk of osteoporosis including hyperthyroidism, Cushing's syndrome, diabetes mellitus, hyperparathyroidism, rheumatoid arthritis, ankylosing spondylitis, tuberculosis, multiple myeloma, leukemia, malnutrition, anorexia nervosa, Celiac disease, Crohn's disease, ulcerative colitis and scurvy.

  9. Medications?

    Why: a history of prolonged use of corticosteroids increases the risk of osteoporosis and resultant fractures; prolonged heparin usage may increase the risk of osteoporosis; Hormone replacement therapy is protective against osteoporosis as it increases the density of bone and reduces rates of vertebral fractures.

  10. Dietary history?

    Why: low calcium intake increases the risk of osteoporosis.

  11. Exercise history?

    Why: regular weight bearing exercise is protective against osteoporosis.

  12. Family history?

    Why: e.g. osteoporosis.

  13. Cigarette smoking?

    Why: increases the risk of osteoporosis.

  14. Caffeine intake?

    Why: High caffeine intake of more than 4 cups of coffee per day increases the risk of osteoporosis.

  15. Alcohol history?

    Why: High alcohol intake of over 2 alcoholic standard drinks per day increases the risk of osteoporosis in women.

Questions your doctor may ask about related symptoms:

Sometimes, other symptoms may be present and may help your doctor analyse your condition. These may include:

  1. Loss of body height?

    Why: Collapse of the vertebral bodies of the spinal column is the hallmark of osteoporosis.

  2. Symptoms of hyperthyroidism?

    Why: e.g. intolerance to heat, sweating of hands, muscle weakness, increased appetite, weight loss, heart palpitations, loose bowel motions, emotional lability, agitation, over activity. Hyperthyroidism causes an increased risk of osteoporosis.

  3. Symptoms of Cushing's syndrome?

    Why: e.g. unexplained weight gain especially central abdominal, change of appearance, moon-like face, thin skin, easy bruising, excessive facial hair growth, acne, muscle weakness, lack of or rare menstrual periods, poor libido, depression, psychosis, insomnia, frequent urination and excessive thirst. Cushing's syndrome causes an increased risk of osteoporosis.

  4. Symptoms of Diabetes mellitus?

    Why: e.g. frequency of urination, excessive thirst, tiredness, fatigue, increased infections especially of the skin and genitals, blurry vision. Diabetes mellitus causes an increased risk of osteoporosis.

  5. Symptoms of Acromegaly?

    Why: e.g. excessive growth of hands, feet, nose, lips, face, jaw and tongue; weakness, sweating, headaches, loss of menstrual periods in females, reduced libido in males. Acromegaly causes an increased risk of osteoporosis.

  6. Symptoms of chronic renal failure?

    Why: e.g. tiredness, reduced appetite, insomnia, frequency of urination, nausea, vomiting, itch. Chronic renal failure causes an increased risk of osteoporosis.

  7. Symptoms of anorexia nervosa?

    Why: e.g. refusal to maintain normal body weight, loss of more than 25% of original body weight, intense fear of becoming fat, preoccupation with calorie counting, avoidance of all carbohydrate, fainting.

  8. The low body weight, absence of menstrual periods and malnutrition all increase the risk of osteoporosis in people with a history of anorexia nervosa
  9. Symptoms of Multiple myeloma?

    Why: e.g. bone pain (e.g. backache), bone tenderness, weakness, tiredness, recurrent infections, bleeding tendency. Multiple myeloma may need to be excluded as an alternative or additional diagnosis to osteoporosis.

  10. Symptoms of bone metastases?

    Why: e.g. bone pain, fractures with minimal trauma, possible history of primary tumor (e.g. lung, breast, esophageal, thyroid, prostate, kidney). Bone metastases may need to be excluded as an alternative or additional diagnosis to osteoporosis.


 » Next page: Types of Osteoporosis

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