Dr. Marcy Bolster, Medical Director of the MUSC Center for Osteoporosis and Bone Health
New MUSC Center for Osteoporosis and Bone Health
Osteoporosis is a disease that is characterized by a loss of bone mass that puts people at increased risk of sustaining a fracture. This disease predominantly affects post-menopausal women; however, it also affects men. Currently there are 10 million Americans over the age of 50 who have osteoporosis and there are additionally 34 million people with low bone mass (also called osteopenia). It is projected that there will be 62 million cases of osteoporosis by the year 2020, thus this represents one of the fastest growing patient populations.
Osteoporosis is detected by a type of x-ray called a dual electron absorptiometry scan or DXA scan. DXA scans reveal the value of the bone mineral density and the relative risk of fracture. It has been shown that bone mineral density is more closely associated with the occurrence of fracture than cholesterol is to the development of coronary heart disease. The impact of osteoporosis on our society is immense. It is known that 40% of women over the age of 50 will suffer an osteoporosis-related fracture in their lifetimes. Moreover, each year, the risk of suffering a fracture from osteoporosis is greater than the combined risk of suffering from a stroke, MI, or breast cancer in women. Osteoporosis results in bone fractures in 1.5 million people per year. Hip fractures due to osteoporosis are just one type of fracture, and hip fractures result in 300,000 hospitalizations per year with an annual health care cost of $18 billion. It is also known that 1 in 5 people who have a hip fracture will die within one year, and that the occurrence of a fracture markedly increases the risk for a patient to have another fracture.
Components of the Center for Osteoporosis and Bone Health
The care of osteoporosis and of bone health at MUSC is unique in that there is an interdisciplinary team of specialists who are devoted to improving the care of patients with these conditions. There are already two services in existence at MUSC to manage fractures in a specialized manner and both of these services will fit under the umbrella of the MUSC Center for Osteoporosis and Bone Health. The two services that exist also take advantage of the expertise of many specialists including orthopaedic surgeons, hospitalists, endocrinologists and rheumatologists for the management of hip fragility fractures, and another group including orthopaedic spine surgeons, neurosurgeons, radiologists, physiatrists, and rheumatologists who collaborate in the management of patients who have had a spine (vertebral) fracture due to osteoporosis.
The goal of the MUSC Center for Osteoporosis and Bone Health is to improve the education of our community of physicians and patients in the management of bone health. Despite its impressive and growing presence in our population, osteoporosis remains a disease that is underrecognized and under-treated. In many studies it has been shown that the medical treatment of patients who have had a hip fracture occurs between 5% and 25% of the time. This can be compared to the institution of betablocker medications after a heart attack, since these medicines are known to improve patient survival, and it has been shown that approximately 93% of patients are prescribed these medications. This discrepancy in care should not be occurring. A large part of improving these statistics will involve the education of those physicians providing fracture care for patients, as well as the education of people in our community to increase awareness of bone health and thus of prevention.
The medical director of the MUSC Center for Osteoporosis and Bone Health is Marcy B. Bolster, MD. She is a Professor of Medicine, Medical Director of the Musculoskeletal Institute, and Director for the Rheumatology Fellowship Training Program. She has been on the faculty at MUSC since 1993 and has been devoted to the development of an interdisciplinary approach to the bone health care of patients.