Letters.

Osteoporosis Symptoms

Although osteoporosis is a common, disabling, and preventable disease, it is underdiagnosed. Most cases are diagnosed late, when the bone is scanned as part of the investigation of a traumatic fracture.

More attention should be given to the symptoms and physical signs of osteoporosis. The most common symptoms are vague body aches, debility fatigue, and muscular weakness. Backache, stiffness of muscles, or paresis may occur. Rheumatic diseases or neurosis are frequently misdiagnosed. Dull aches mimic neuralgia. A woman may wake up with stiffness or even a spontaneous fracture, especially of the femur. Any perimenopausal woman sustaining a fracture is a candidate for a bone densitometry study. The gait may be abnormal, with falls and ankle sprains.

Bone pains are frequent and pressure on them provokes pain. The curvature of the spine may be altered. Pain can be produced by pressure on the spine, pelvis, or ribs.

Finally, osteoporosis and osteomalacia may coexist, as alkaline phosphatase may remain normal in some cases of osteomalacia. Osteopenia and osteoporosis should be considered in all patients with rheumatic diseases or intervertebral disk lesions.

N.G. Mussalli, M.D.

New York