What the Experts Say
I specialise in the treatment of arthritis and other rheumatic diseases that affect joints, muscles, bones and skin. Patients can be referred to me from a General Practitioner for a variety of conditions including arthritis, autoimmune diseases, musculoskeletal pain, disorders of the musculoskeletal system and osteoporosis. The majority of patients that are referred are in considerable pain.
For example, in the case of rheumatoid arthritis, this manifests itself as swelling and stiffness in the joints. Receiving a diagnosis of rheumatoid arthritis is a life changing event since this is a chronic condition. Treatment regimens to reduce joint inflammation include oral, intravenous or intramuscular steroids.
I recommend that all my patients who are receiving long-term steroid therapy have their bone density assessed and monitored on an ongoing basis. While rheumatoid arthritis has the potential to damage joints leading to deformity and loss of function, related complications associated with osteoporosis can be prevented and managed successfully when addressed early.
In Merlin Park we have a bone density measurement service that provides a DEXA scanning opportunity to the public free of charge via their GPs. This service is unique in Ireland and aims to provide a resource whereby the assessment and treatment of osteoporosis is provided to patients in the community.
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As an orthopaedic surgeon I am concerned with diseases, injuries and conditions of the body's muscles and skeleton, that include joints, ligaments, tendons and nerves. The most common type of fracture I encounter is the hip fracture and this is generally associated with significant pain, disability and functional dependence for the patient. Collapsed vertebrae may be felt or seen in the form of severe back pain, loss of height or spinal deformities.
I am conscious that fractures are the late consequences of osteoporosis and a prior fracture is one of the strongest risk factors for future fractures. For example the occurrence of a vertebral fracture increases two-to-five fold the risk of another fracture within the next year. As the operating surgeon, I have an opportunity and responsibility to think about and institute mechanisms for preventing future fractures.
I recommend that every patient I treat for a hip, spine, wrist, forearm or pelvic fracture has a DEXA scan to determine if this fracture is the result of osteoporosis. Similarly I recommend that every patient that I see over 50 with a history of fractures undergoes a bone density scan.
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I specialise in establishing and maintaining the overall health of women throughout their lifespan. Women present to me with a variety of conditions ranging from infertility problems to menopause. As a woman ages hormone production declines progressively, resulting in irregular menstrual cycles and finally cessation of menstruation. Bone loss is accelerated when women experience oestrogen deficiency and menstrual irregularity. Given the risk factors for osteoporosis, I recommend that all of my post menopausal patients, those experiencing early menopause or an early hysterectomy, and those of any age who have missed periods for prolonged periods have their bone density assessed.
After the menopause, women lose about 2% of their bone density per year and within 10 years of menopause many women who may have approached the menopause with a low bone mass are below the fracture threshold. Therefore early detection of risk is mandatory for prevention of the disease and I recommend that all women with suspected oestrogen deficiency should be monitored.
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| Rheumatologist | Dr. Robert Coughlan Consultant Rheumatologist, Merlin Park Regional Hospital, Galway |
I specialise in the treatment of arthritis and other rheumatic diseases that affect joints, muscles, bones and skin. Patients can be referred to me from a General Practitioner for a variety of conditions including arthritis, autoimmune diseases, musculoskeletal pain, disorders of the musculoskeletal system and osteoporosis. The majority of patients that are referred are in considerable pain.
For example, in the case of rheumatoid arthritis, this manifests itself as swelling and stiffness in the joints. Receiving a diagnosis of rheumatoid arthritis is a life changing event since this is a chronic condition. Treatment regimens to reduce joint inflammation include oral, intravenous or intramuscular steroids.
I recommend that all my patients who are receiving long-term steroid therapy have their bone density assessed and monitored on an ongoing basis. While rheumatoid arthritis has the potential to damage joints leading to deformity and loss of function, related complications associated with osteoporosis can be prevented and managed successfully when addressed early.
In Merlin Park we have a bone density measurement service that provides a DEXA scanning opportunity to the public free of charge via their GPs. This service is unique in Ireland and aims to provide a resource whereby the assessment and treatment of osteoporosis is provided to patients in the community.
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| Orthopaedic Surgeon | Professor David Marsh Professor of Orthopaedics, Queen's University, Belfast |
As an orthopaedic surgeon I am concerned with diseases, injuries and conditions of the body's muscles and skeleton, that include joints, ligaments, tendons and nerves. The most common type of fracture I encounter is the hip fracture and this is generally associated with significant pain, disability and functional dependence for the patient. Collapsed vertebrae may be felt or seen in the form of severe back pain, loss of height or spinal deformities.
I am conscious that fractures are the late consequences of osteoporosis and a prior fracture is one of the strongest risk factors for future fractures. For example the occurrence of a vertebral fracture increases two-to-five fold the risk of another fracture within the next year. As the operating surgeon, I have an opportunity and responsibility to think about and institute mechanisms for preventing future fractures.
I recommend that every patient I treat for a hip, spine, wrist, forearm or pelvic fracture has a DEXA scan to determine if this fracture is the result of osteoporosis. Similarly I recommend that every patient that I see over 50 with a history of fractures undergoes a bone density scan.
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| Gynaecologist | Dr. Martine Millett-Johnston Consultant in Gynaecology, Kilkenny |
I specialise in establishing and maintaining the overall health of women throughout their lifespan. Women present to me with a variety of conditions ranging from infertility problems to menopause. As a woman ages hormone production declines progressively, resulting in irregular menstrual cycles and finally cessation of menstruation. Bone loss is accelerated when women experience oestrogen deficiency and menstrual irregularity. Given the risk factors for osteoporosis, I recommend that all of my post menopausal patients, those experiencing early menopause or an early hysterectomy, and those of any age who have missed periods for prolonged periods have their bone density assessed.
After the menopause, women lose about 2% of their bone density per year and within 10 years of menopause many women who may have approached the menopause with a low bone mass are below the fracture threshold. Therefore early detection of risk is mandatory for prevention of the disease and I recommend that all women with suspected oestrogen deficiency should be monitored.
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