Osteoporosis

What is Osteoporosis ?

It is a condition with decreased bone mineral density. It's a major health problem affecting 10 million

Americans. It increases porosity inside bones leading to increased risk of fracture .



                                  Bone With Osteoperosis - Royalty-free Osteoporosis Stock Photo

                                     Normal bone (left ) and porosity in Osteoporotic bone (right )



What are the risk factors for this problem ?

Risk factors for  Osteoporosis

A. Life-style

    Alcohol

    Excess vitamin A

    Frequent falls

    Prolonged bed rest

     Low calcium intake

     Tobaccoo use

     High caffeine

      High salt

      low body mass index


B. Genetic factors

       Cystic Fibrosis

        Haemochromatosis

      Marfan disease

        Glycogen storage disease

       Haemochromatosis

        Homocystinuria

       Osteogenesis Imperfecta

        Parental history of hip fracture

         Porphyria

C. Hormonal disorder

        Turner Syndrome

         Androgen insensitivity

         Anorexia Nervosa

         Panhypopituirasim

         Premature ovarian failure

         Diabetes Mellitus


         Hyperparathyroidism

        Thyrotoxicosis


D.Gatrointestinal Disorders

        Celiac disease

         Gastric bypass
       
          Inflammatory disease

         Primary Billiary Cirrhosis

E. Blood Disorders

         Leukemia

         Thallasaemia

        Sickle cell disorder

     
F. Autoimmune Disease

      Rheumatoid disease

       Ankylosing Spondylitis

      Systemic Lupus Erythematous


G. Drugs and therapy

      Anticoagulants

      Drugs for seizure disorders

      Anticancer drugs

     Radiation therapy

      Steroidal drugs

    Lithium


H. Others

   Depression

   Multiple Sclerosis

   Idiopathic Scoliosis


     Emphysema

     End stage renal disease

      Amyloidosis


How is this diagnosed ?

This is diagnosed by using DEXA scan . T score more than 2.5 SD below average is Osteoporosis.


What's the risk associated with this problem ?

 This problem leads to fracture even with low energy trauma. And this adds morbidity.

They may sustain vertebral fracture even with coughing and sneezing which leads to sudden onset of

back-ache with kyphosis. There may be nerve compression and pain may radiate down to legs.

If people suffer hip fracture secondary to Osteoporosis due to low enrgery fall , there is risk of death

as high as 50 % because hip fracture gets further complicated with  Deep venous thrombosis and

pulmonary embolism  , Bed sores , Pnumonia etc. which might be fatal . This may occur upto 1 year

after hip fracture.



How do you prevent and treat ?

Prevention can be done avoiding risk factors if possible.

 Calcium and Vitamin D supplement


Weight bearing


avoid alcohol , prolonged immobilization ,


Treatments ;

        Bisphosphonates - Zolidronic acid

        Selective Esotrgen Receptor Modulators - Raloxifene

         Hormone therapy

         Parathyoid Hormone

         Calcitonin


          Denosumab

     


please comment or send me email if someone wants to discuss more on this topic.


   
































 










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