Two frequent diseases that are commonly confused with one another are osteoporosis and osteoarthritis.

Osteoarthritis is a common joint disease due to multiple factors, including local inflammation, mechanical forces (use of the joints), genectic predisposition, and cellular dysfunction of the components of the joint. Osteoarthritis commonly affects the hands, shoulders, knees, hips, neck, and low back. It is more common after age 40, but trauma and other genetic factors could accelerate the time of onset.

Osteoporosis on the other hand, is decreased bone mass due to micro-architectural disruption with a resulting high risk for a fracture. Think about the construction of a building — if the frame is not properly built, then the building will collapse.

The diagnosis of osteoarthritis is usually based on the patient’s history, physical exam, and radiographic findings. Whereas in osteoporosis, DXA (a technique called dual-energy X-ray Absorptiometry) is used for the diagnosis. A patient who has had a fragility fracture (or low impact) is also considered to have osteoporosis. These patients should consult with their doctors when a fracture occurs to see if treatment should be instituted.

Adahli E. Massey, MD, FACR