© 2020 Texas Public Radio
Real. Reliable. Texas Public Radio.
Play Live Radio
Next Up:
Available On Air Stations

Fracture Prevention Clinics Target Osteoporosis

Osteoporosis, or brittle bone disease, is a common problem of aging. Specialists say the health condition is under-diagnosed and under-treated. That means some painful, life-changing fractures that could be prevented are not. 

Cassandra Barnes is not your typical osteoporosis patient. When she was only 50, she fell, an accident that caused multiple fractures.


"And I broke both my wrists, my kneecap and a thumb just from tripping over a curb," she explained.

A primary care physician dismissed Barnes' questions about osteoporosis, saying she was too young to be concerned.  Just three short years later, at age 53, she was diagnosed with extremely low bone mass and sought help.

Credit Wendy Rigby / Texas Public Radio
Texas Public Radio
Cassandra Barnes has her blood drawn to check her vitamin D levels.


"We have over two million people who have been diagnosed with osteoporosis," said James Simmons, MD, a San Antonio orthopedic surgeon specializing in spinal surgery. "But I think that just hits the tip of the iceberg."

Simmons calls osteoporosis a growing epidemic, evidenced by the treatment of 300,000 hip fractures a year in the U.S.

"Once somebody has a fracture like that, their quality of life greatly deteriorates," Simmons observed. "At two years, 50 percent of people with a hip fracture will unfortunately no longer be around."

That’s why a new model of care is emerging. These specialty programs are called Fracture Prevention Clinics or Fracture Liaison Services. The one at South Texas Spinal Clinic has been helping more than a hundred patients a month for the past two years.

Credit Wendy Rigby / Texas Public Radio
Texas Public Radio
Lynne Williams gets a DEXA bone scan to gauge her osteoporosis.


The evaluation starts with a DEXA scan for bone density, a painless test that yields a lot of useful diagnostic information.

That test is followed up with blood work to determine if vitamin D deficiencies are also at play.

The fracture liaison services are certified through the National Osteoporosis Foundation. The idea is to get more people on bone building treatments or vitamins or exercise regimens before they ever break a bone. Crystal Rolleg is a physician assistant who is a provider for the Stone Oak clinic.

"Patients that do experience osteoporotic related fractures are only treated about 20 percent of the time for the cause of the fracture," Rolleg said.

James Simmons, MD, is an orthopedic surgeon who specializes in spine surgery.


Lynne Williams, 77, is hoping an ounce of prevention is indeed worth a pound of cure. When she fractured a vertebrae after a fall, she was sent to the fracture prevention clinic for evaluation.

"The folks out here did the bone density test," Williams said. "And I had let it go too long."

Williams has been put on daily injections of a bone building drug that she gives to herself. After her first four months, she’ll be evaluated to see if it’s helping.

"I’m very hopeful. Yes. I am," she stated. "Indeed. You know, I’m of an age now there are lots of people around me who are fracturing this and fracturing that and I don’t even think they know that there’s a game on."

Age isn’t the only risk factor. Barnes, for instance, had a hysterectomy at a young age, and lacked protective hormones. She says women need to advocate for themselves if they suspect brittle bones are a problem.

"Get your bones checked," Barnes emphasized. "To have a place to go and actually diagnose it, prevent it, educate. It’s a great program."


Physician Assistant Crystal Rolleg is a Fracture Liaison Certified Specialist.


Her therapy has helped. "I’ve had falls. I’ve had no further fractures," she said.

Since fractures can be costly, even deadly for some people, insurance usually covers the cost of fracture prevention clinic visits and treatments.