CLINICAL CUES

Osteoporosis is not readily identifiable by physical examination, as it gives no clues as to its presence until the discovery of a fracture. The clinical diagnosis of osteoporosis maybe made on physical examination alone in those patients who have already suffered osteoporotic fractures. Features that raise suspicion of osteoporosis include reduced height, kyphosis (a forward curvature of the thoracic spine), and a protuberant abdomen, all of which may result from vertebral fractures.¹ 

Risk factors that increase the likelihood that a patient may have low bone mass are described in the previous section on pathophysiology. Although, they may help to identify some patients at risk for osteoporosis, these factors alone are ineffective as a prescreening device because of failure to identify a large number of patients with low bone mass. 

In all cases, a careful patient interview should be conducted to identify potential risk factors for osteoporosis. This information should include any history of fracture suffered after the age of 40 as it has been observed that history of fracture in adulthood, independent of bone mass, roughly doubles the risk of another fracture.²

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