Diagnosis of osteoporosis in rural Arctic Greenland: a clinical case using plain chest radiography for secondary prevention and consideration of tools for primary prevention in remote areas

Inuuteq Fleischer; Louise K Schæbel; Nadja Albertsen; Vibeke N Sørensen; Stig Andersen

doi:10.22605/rrh3910

Diagnosis of osteoporosis in rural Arctic Greenland: a clinical case using plain chest radiography for secondary prevention and consideration of tools for primary prevention in remote areas

Inuuteq Fleischer, Louise K Schæbel, Nadja Albertsen, Vibeke N Sørensen, Stig Andersen

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

CONTEXT: Osteoporosis is a frequent disease in many populations. The hallmark is fragility fractures, which are harbingers of future fractures, disability, mortality and cost on society. The occurrence increases with age, low vitamin D level and smoking. Smoking rates are high, vitamin D is low and life expectancy is rising steeply in Greenland, as is the need for focus on osteoporosis. We report a case that uses a simple and readily available tool to diagnose osteoporosis at the hospital in Sisimiut, a town of 5000 inhabitants on the west coast of Greenland.

ISSUES: A 51-year-old Inuit woman was seen due to lower back pain. No trauma could be recalled. Laboratory results showed a low vitamin D level and normal S-calcium, S-phosphate, S-parathyroid hormone, S-thyrotropin, erythrocyte sedimentation rate, S-creatinine and hemoglobin. The lateral chest radiograph demonstrated a reduction of anterior height of the seventh and ninth thoracic vertebral bodies of 50% and 40% respectively.

LESSONS LEARNED: Chest radiographs are frequently done in the towns along the vast coastline of Greenland, the world's largest island. They are transferred to the hospital in the capital city Nuuk using existing tele-technology, and specialist evaluations are given in electronic records available at the coastal hospitals. Effective therapies for osteoporosis are available and the identification of vertebral fractures that merit treatment may prevent future fractures, morbidity and mortality. Fragility fractures are frequent in old age and the steep rise in life expectancy and in the number of old people in Greenland emphasize the need for a focus on management of osteoporosis. Geography provides a diagnostic challenge to rural and remote areas that can be overcome by the use of lateral chest radiographs as it relies on facilities readily available. Clinical risk assessment tools with high specificity may support further osteoporosis risk prediction in remote Arctic societies.

Originalsprog	Engelsk
Tidsskrift	Rural and Remote Health
Vol/bind	17
Nummer	1
Sider (fra-til)	3910
ISSN	1445-6354
DOI	https://doi.org/10.22605/rrh3910
Status	Udgivet - 2017

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Grønland
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10.22605/rrh3910

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title = "Diagnosis of osteoporosis in rural Arctic Greenland: a clinical case using plain chest radiography for secondary prevention and consideration of tools for primary prevention in remote areas",

abstract = "CONTEXT: Osteoporosis is a frequent disease in many populations. The hallmark is fragility fractures, which are harbingers of future fractures, disability, mortality and cost on society. The occurrence increases with age, low vitamin D level and smoking. Smoking rates are high, vitamin D is low and life expectancy is rising steeply in Greenland, as is the need for focus on osteoporosis. We report a case that uses a simple and readily available tool to diagnose osteoporosis at the hospital in Sisimiut, a town of 5000 inhabitants on the west coast of Greenland.ISSUES: A 51-year-old Inuit woman was seen due to lower back pain. No trauma could be recalled. Laboratory results showed a low vitamin D level and normal S-calcium, S-phosphate, S-parathyroid hormone, S-thyrotropin, erythrocyte sedimentation rate, S-creatinine and hemoglobin. The lateral chest radiograph demonstrated a reduction of anterior height of the seventh and ninth thoracic vertebral bodies of 50% and 40% respectively.LESSONS LEARNED: Chest radiographs are frequently done in the towns along the vast coastline of Greenland, the world's largest island. They are transferred to the hospital in the capital city Nuuk using existing tele-technology, and specialist evaluations are given in electronic records available at the coastal hospitals. Effective therapies for osteoporosis are available and the identification of vertebral fractures that merit treatment may prevent future fractures, morbidity and mortality. Fragility fractures are frequent in old age and the steep rise in life expectancy and in the number of old people in Greenland emphasize the need for a focus on management of osteoporosis. Geography provides a diagnostic challenge to rural and remote areas that can be overcome by the use of lateral chest radiographs as it relies on facilities readily available. Clinical risk assessment tools with high specificity may support further osteoporosis risk prediction in remote Arctic societies.",

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author = "Inuuteq Fleischer and Sch{\ae}bel, {Louise K} and Nadja Albertsen and S{\o}rensen, {Vibeke N} and Stig Andersen",

year = "2017",

doi = "10.22605/rrh3910",

language = "English",

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pages = "3910",

journal = "Rural and Remote Health",

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Diagnosis of osteoporosis in rural Arctic Greenland: a clinical case using plain chest radiography for secondary prevention and consideration of tools for primary prevention in remote areas. / Fleischer, Inuuteq; Schæbel, Louise K; Albertsen, Nadja et al.
I: Rural and Remote Health, Bind 17, Nr. 1, 2017, s. 3910.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Diagnosis of osteoporosis in rural Arctic Greenland

T2 - a clinical case using plain chest radiography for secondary prevention and consideration of tools for primary prevention in remote areas

AU - Fleischer, Inuuteq

AU - Schæbel, Louise K

AU - Albertsen, Nadja

AU - Sørensen, Vibeke N

AU - Andersen, Stig

PY - 2017

Y1 - 2017

N2 - CONTEXT: Osteoporosis is a frequent disease in many populations. The hallmark is fragility fractures, which are harbingers of future fractures, disability, mortality and cost on society. The occurrence increases with age, low vitamin D level and smoking. Smoking rates are high, vitamin D is low and life expectancy is rising steeply in Greenland, as is the need for focus on osteoporosis. We report a case that uses a simple and readily available tool to diagnose osteoporosis at the hospital in Sisimiut, a town of 5000 inhabitants on the west coast of Greenland.ISSUES: A 51-year-old Inuit woman was seen due to lower back pain. No trauma could be recalled. Laboratory results showed a low vitamin D level and normal S-calcium, S-phosphate, S-parathyroid hormone, S-thyrotropin, erythrocyte sedimentation rate, S-creatinine and hemoglobin. The lateral chest radiograph demonstrated a reduction of anterior height of the seventh and ninth thoracic vertebral bodies of 50% and 40% respectively.LESSONS LEARNED: Chest radiographs are frequently done in the towns along the vast coastline of Greenland, the world's largest island. They are transferred to the hospital in the capital city Nuuk using existing tele-technology, and specialist evaluations are given in electronic records available at the coastal hospitals. Effective therapies for osteoporosis are available and the identification of vertebral fractures that merit treatment may prevent future fractures, morbidity and mortality. Fragility fractures are frequent in old age and the steep rise in life expectancy and in the number of old people in Greenland emphasize the need for a focus on management of osteoporosis. Geography provides a diagnostic challenge to rural and remote areas that can be overcome by the use of lateral chest radiographs as it relies on facilities readily available. Clinical risk assessment tools with high specificity may support further osteoporosis risk prediction in remote Arctic societies.

AB - CONTEXT: Osteoporosis is a frequent disease in many populations. The hallmark is fragility fractures, which are harbingers of future fractures, disability, mortality and cost on society. The occurrence increases with age, low vitamin D level and smoking. Smoking rates are high, vitamin D is low and life expectancy is rising steeply in Greenland, as is the need for focus on osteoporosis. We report a case that uses a simple and readily available tool to diagnose osteoporosis at the hospital in Sisimiut, a town of 5000 inhabitants on the west coast of Greenland.ISSUES: A 51-year-old Inuit woman was seen due to lower back pain. No trauma could be recalled. Laboratory results showed a low vitamin D level and normal S-calcium, S-phosphate, S-parathyroid hormone, S-thyrotropin, erythrocyte sedimentation rate, S-creatinine and hemoglobin. The lateral chest radiograph demonstrated a reduction of anterior height of the seventh and ninth thoracic vertebral bodies of 50% and 40% respectively.LESSONS LEARNED: Chest radiographs are frequently done in the towns along the vast coastline of Greenland, the world's largest island. They are transferred to the hospital in the capital city Nuuk using existing tele-technology, and specialist evaluations are given in electronic records available at the coastal hospitals. Effective therapies for osteoporosis are available and the identification of vertebral fractures that merit treatment may prevent future fractures, morbidity and mortality. Fragility fractures are frequent in old age and the steep rise in life expectancy and in the number of old people in Greenland emphasize the need for a focus on management of osteoporosis. Geography provides a diagnostic challenge to rural and remote areas that can be overcome by the use of lateral chest radiographs as it relies on facilities readily available. Clinical risk assessment tools with high specificity may support further osteoporosis risk prediction in remote Arctic societies.

KW - Female

KW - Greenland

KW - Healthcare Disparities

KW - Humans

KW - Middle Aged

KW - Osteoporosis/diagnostic imaging

KW - Primary Prevention/methods

KW - Rural Health Services/organization & administration

KW - Secondary Prevention/methods

KW - Grønland

KW - Knogleskørhed

U2 - 10.22605/rrh3910

DO - 10.22605/rrh3910

M3 - Journal article

C2 - 28201922

SN - 1445-6354

VL - 17

SP - 3910

JO - Rural and Remote Health

JF - Rural and Remote Health

IS - 1

ER -

Diagnosis of osteoporosis in rural Arctic Greenland: a clinical case using plain chest radiography for secondary prevention and consideration of tools for primary prevention in remote areas

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