Low rate of densitometric diagnosis and treatment in patients with severe osteoporosis in Colombia



Our study describes the clinical characteristics of patients with fragility fractures. It also shows there is a low knowledge about osteoporosis and its relation to fractures, in addition to the very poor adherence to medical advice and treatment.


Osteoporosis is a systemic skeletal disease associated with an increased risk of fragility fractures and is a public health problem worldwide due to population aging. Early osteoporosis diagnosis and treatment is very important for reducing the incidence of fragility fractures and the resulting complications. Our study describes the clinical characteristics of patients with fragility fractures and their risk factors, evaluates the level of knowledge that patients have about osteoporosis, and follows-up on each case to establish if, after the fracture, a densitometric diagnosis was made and the patient received specific treatment in his outpatient follow-up through his health insurance plan.


A descriptive cross-sectional study was carried out in a university hospital in Bogotá, Colombia. The data was collected by means of a questionnaire, administered to all patients admitted by the orthopedic emergency department with a diagnosis of fragility fracture. After discharge, a telephone follow-up was done every 3 months for 1 year, and patients were asked if they had already had the dual X-ray absorptiometry (DXA) scan and if they had begun osteoporosis treatment.


A total of 111 patients with an average age of 74.4 years (± 11.3 years), of which 84 (75.6%) were women, all consulted for osteoporotic fracture at the orthopedic emergency department of the hospital. Hip fracture was the most frequent (51.4%), followed by vertebral (23.4%), wrist (22.5%), and humerus (4.5%) fracture. A total of 49.5% (n = 55) of the patients did not know what osteoporosis is; 58.6% (n = 65) did not know that fracture is the main complication of this disease, and 62.2% (n = 69) did not associate fractures with osteoporosis. All patients were educated about osteoporosis and the importance of diagnosing and treating it. Patients were given a medical order to have a DXA scan upon discharge; however, only 24.3% (n = 27) had the DXA scan in the first year of the fracture. A total of 33.3% (n = 37) received calcium plus vitamin D, and only 9.9% (n = 11) received osteoporosis treatment (7 bisphosphonate patients and 4 denosumab). No patient received osteoformative therapy.


Our study shows that Colombian patients have little knowledge about osteoporosis and its relationship with fragility fractures. It also shows that densitometries are not done and, what is worse, patients with a diagnosis of fracture have limited access to treatment after discharge.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. 1.

    NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy D and T (2001) Osteoporosis prevention, diagnosis, and therapy. JAMA J Am Med Assoc 285(6):785–795

    Article  Google Scholar 

  2. 2.

    Cooper C, Campion G, Melton LJ (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2(6):285–289

    CAS  Article  Google Scholar 

  3. 3.

    Marks R (2010) Hip fracture epidemiological trends, outcomes, and risk factors, 1970-2009. Int J Gen Med 3:1–17

    PubMed  PubMed Central  Google Scholar 

  4. 4.

    Zanchetta J et al (2012) The latin america regional audit: Epidemiología, costos e impacto de la osteoporosis en 2012. [cited 2019 Mar 24]. p. 33–5. Available from: www.iofbonehealth.org

  5. 5.

    Clark P, Cons-Molina F, Deleze M, Ragi S, Haddock L, Zanchetta JR, Jaller JJ, Palermo L, Talavera JO, Messina DO, Morales-Torres J, Salmeron J, Navarrete A, Suarez E, Pérez CM, Cummings SR (2009) The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS). Osteoporos Int 20(2):275–282

    CAS  Article  Google Scholar 

  6. 6.

    Schnell S, Friedman SM, Mendelson DA, Bingham KW, Kates SL (2010) The 1-year mortality of patients treated in a hip fracture program for elders. Geriatr Orthop Surg Rehabil 1(1):6–14

    Article  Google Scholar 

  7. 7.

    Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 22(3):465–475

    Article  Google Scholar 

  8. 8.

    Yusuf AA, Matlon TJ, Grauer A, Barron R, Chandler D, Peng Y (2016) Utilization of osteoporosis medication after a fragility fracture among elderly Medicare beneficiaries. Arch Osteoporos 11(1):31

    Article  Google Scholar 

  9. 9.

    Hajcsar EE, Hawker G, Bogoch ER (2000) Investigation and treatment of osteoporosis in patients with fragility fractures. CMAJ. 163(7):819–822

    CAS  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Rodríguez PJA, Borzutzky SA, Barnett TC, Marín LPP (2003) Falta de reconocimiento de osteoporosis y omisión de tratamiento en adultos mayores con fractura de cadera en Chile. Rev Med Chil 131(7):773–778

    Article  Google Scholar 

  11. 11.

    van den Bergh JP, van Geel TA, Geusens PP (2012) Osteoporosis, frailty and fracture: implications for case finding and therapy. Nat Rev Rheumatol 8(3):163–172

    Article  Google Scholar 

  12. 12.

    Åkesson K, Marsh D, Mitchell PJ, McLellan AR, Stenmark J, Pierroz DD et al (2013) Capture the Fracture: a Best Practice Framework and global campaign to break the fragility fracture cycle. Osteoporos Int 24(8):2135–2152

    Article  Google Scholar 

  13. 13.

    Giangregorio L, Thabane L, Cranney A, Adili A, deBeer J, Dolovich L, Adachi JD, Papaioannou A (2010) Osteoporosis knowledge among individuals with recent fragility fracture. Orthop Nurs 29(2):99–107

    CAS  Article  Google Scholar 

  14. 14.

    Díaz-Correa LM, Ramírez-García LM, Castro-Santana LE, Vilá LM (2014) Osteoporosis knowledge in patients with a first fragility fracture in Puerto Rico. Bol Asoc Med P R 106(1):6–10

    PubMed  Google Scholar 

  15. 15.

    Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(S02):S3–S7

    Article  Google Scholar 

  16. 16.

    Sorbi R, Aghamirsalim MR (2012) Knowledge of orthopaedic surgeons in managing patients with fragility fracture. Int Orthop 36(6):1275–1279

    Article  Google Scholar 

  17. 17.

    Kothawala P, Badamgarav E, Ryu S, Miller RM, Halbert RJ (2007) Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis. Mayo Clin Proc 82(12):1493–1501

    Article  Google Scholar 

  18. 18.

    Dell R (2011) Fracture prevention in Kaiser Permanente Southern California. Osteoporos Int 22(S3):457–460

    Article  Google Scholar 

  19. 19.

    Aghamirsalim M, Mehrpour SR, Kamrani RS, Sorbi R (2012) Effectiveness of educational intervention on undermanagement of osteoporosis in fragility fractures. Arch Orthop Trauma Surg 132(10):1461–1465

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Daniel G. Fernández-Ávila.

Ethics declarations

The work was approved by the Clinical and Ethical Research Committee of the Pontificia Universidad Javeriana in Bogotá, Colombia.

Conflicts of interest


Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Fernández-Ávila, D.G., Rincón-Riaño, D.N., Pinzón, D.F. et al. Low rate of densitometric diagnosis and treatment in patients with severe osteoporosis in Colombia. Arch Osteoporos 14, 95 (2019). https://doi.org/10.1007/s11657-019-0646-6

Download citation


  • Osteoporosis
  • Osteoporosis fracture
  • Fragility fractures
  • Colombia