Let’s take a look at these risk factors we talked to dr. Tom I want to start with a gender I know I mentioned is it more prevalent in females or male so yes this is a good list of risk factors certainly gender is a risk factor and it is more common that we see osteoporosis in women than we do in men age the next one we usually see this more after age 50 that can be related to the hormone changes that most women go through with menopause so certainly after the age of 50 but it could be younger depending on certain medical conditions and medications that you may be taking there are some race and ethnic predispositions that we see certainly the Asian ethnicity tends to have a little bit more of osteoporosis family history has to do with whether your grandparents or your parents had a diagnosis of osteoporosis that you know you want to discuss with your physician because that may increase your risk and then body frame size petite and thin body frames tend to be more at risk for osteoporosis and that really has to do with the amount of bone density certainly having a smaller frame suggest that you may have a lesser density not dr. Sharma dr. Carson let’s switch gears a little bit and talk about diagnosing osteoporosis so both of you are very important for this question because how is it diagnosed and then how soon after is it diagnosed our patients gonna go see someone like dr. Corsa so let’s talk start with you dr. Sharma sure so certainly when you have your annual preventative wellness visit your physician will discuss bone density screenings with you another time that we may discuss bone density screening or evaluation will be after a fracture to identify if there is an underlying cause of osteoporosis but just as dr. corsa mentioned earlier it’s not uncommon that a patient will be referred back to the physical from physical therapy to the primary care physician because of a finding that dr. Corsa or another physical therapist may come across during their evaluations you