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Avatar universal

Which health factors increase chances of osteoporosis?

I am 29 and in good health but my doctor believes I may have osteoporosis/osteopenia.

I have a healed pelvic fracture from December 2015 but my recent MRI shows more weakening/thinning of the pelvic bone in a different area and he says another fracture may be likely.

I do not drink excessively or smoke. I have been vegetarian for 8 years but I take Calcium and vit D supplements daily.

Does anyone know why this could happen?
2 Responses
Avatar universal
It would be exceedingly rare for a 29 year old to have osteoporosis. Aside from genetics, there are secondary causes of osteoporosis (ie those that are not related to aging). These include certain medical diseases (hyperparathyroidism, hyperthyroidism, rheumatoid arthritis, among many others) as well as use of certain medications (oral steroids, chemotherapy, among others). At 29, these pelvic fractures may be stress-related. Are you active with sports, running? Overuse injuries can lead to stress fractures in the pelvis, which doesn't necessarily indicate osteoporosis.

I would recommend a thorough screening for osteoporosis (which includes a medical history, labs for secondary causes, and a DXA bone density scan). Discuss this with your medical provider.

3 Comments
Stress fractures occur in a "spectrum" if you will. It varies from a "stress reaction" which shows up as swelling within the bone, to a stress fracture which obviously has a fracture line present. Assuming this did not occur from a fall or other traumatic injury, then it is likely related to overuse. I have personally evaluated patients for osteoporosis with prior overuse pelvic fractures who ultimately had normal bone density on their DXA scan. Stress fractures themselves are not indicative of osteoporosis. Fragility fractures-- which include a fracture of the hip, pelvis, wrist, spine, or shoulder sustained during a fall from standing height-- are concerning for osteoporosis.

It is probably worth a baseline screening with a DXA scan, along with a basic panel of labs evaluating for possible secondary causes of low bone density/recurrent stress fractures. If nothing else, this will provide reassurance. Please provide updated once available.

OrthoAdvisor
Thank you for your answer. Yes, I was an active runner but only about 20 mi/week on average. I just had DXA scan yesterday and am awaiting the results. The ortho surgeon showed me the MRI image which indicated bruising inside the pelvic bone (edema?) and he says it may fracture again if I try to run.

I am just so tired of dealing with this. The fracture happened last December and I'm still not healed yet. It was likely an overuse injury I guess, but I have been running long distance since junior high, never had anything like this.

Thank you for your insight.
Update:

Bone scan results were normal with no signs of osteoporosis. Sports medicine physician believes the fracture was caused by overuse and poor biomechanics/gait abnormality. He is referring me to physical therapy for further evaluation.

I have morton's neuroma on left foot and it's possible that this has been causing me to walk unstable for quite some time now. The running caused the muscles to strain and pull on that side resulting in the fracture. I hope this is truly the cause as I don't want it to be a recurring issue.
973741 tn?1342346373
Any update on this situation?  Been a long while.  Wondering what ended up happening.
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