Osteoporosis
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Osteoporosis is a common bone disorder characterized by systemic decreased of bone mass and microarchitecture impairment result in fragility fracture. Osteoporosis is common in old age group, particularly postmenopausal women. Different research shows that about 40% of postmenopausal women are affected by osteoporosis and lifetime facture risk of an osteoporotic patient is as high as 40%. Spine, hip or wrist factures are the common factures due to osteoporosis but other bones including trochanter, ribs or humerus can also be affected.
What causes the osteoporosis?Osteoporosis occurs due to imbalance between new bone formation and old bone resorption. In osteoporosis body fail to form enough new bone or used too much old bone or both.
What are the risk factors of osteoporosis?
- Postmenopausal women (due to the drop in estrogen level)
- Hyperparathyroidism
- Vitamin Deficiency
- Corticosteroid medication, antidepressant medication such as serotonin reuptake inhibitors (SSRIs)
- Rheumatoid arthritis
- Kidney disease, anorexia nervosa or anorexia bulimia
- Amenorrhea (absent of menstruation)
- Chronic alcohol intake
- Family history
- Smoking
- Hyperthyroidism
- Sedentary lifestyle
- Low calcium intake
What are the signs and symptoms of osteoporosis?
- Bone pain or bone tenderness
- Back pain or neck pain mind to severe due to spinal bones factures
- Loss of height
- Stooped posture (Kyphosis also called dowager’s hump)
- Fracture at other sites of the bones.
How is osteoporosis diagnosed?
Diagnosis relies on radiological imaging which includes:
- Dual energy X-ray absorptiometry: This is the gold standard to diagnosed osteoporosis. It measures the density of bones in spine wrist and hip
- Ultrasound
- Computerized tomography (CT) scans
- Spine or hip X-ray
How is osteoporosis management?
- Regular exercises
- Food which have high calcium level such as cheese, ice cream, spinach, tofu, yogurt, low fat milk
- Take at least 800-1,000 international units of vitamin D3 and 1200 milligrams of calcium per day
- Decreased risk of falls and decrease factures
- Wearing well fitting shoes and sandals
Different medications are available to managed osteoporosis which includes:
- Calcitonin: Medication that slows the rate of bone loss
- Bisphosphonates: Main drug to managed postmenopausal women, biphosphonates includes alendronate and risedronate taken by mouth one a week or once a month.
- Hormone replacement therapy (HRT): Estrogen has helped in postmenopausal women.
- Parathyroid hormone therapy such as teriparatide.
- Denosumab, odanacatib, saracatinib are the latest antiresoportive drugs for osteoporosis
- MK-5442, AMG 785 and BHQ880 are the latest anabolic drugs for osteoporosis.
What is the prognosis of osteoporosis?
Medication can help to prevent further progress of osteoporosis but can not reserved collapsed vertebrae.
References:
- Osteoporosis: now and the future Tilman D Rachner MDa, Prof Sundeep Khosla MDb and Prof Lorenz C Hofbauer MD , march 2011
- NIH Consensus Development Panel on Osteoporosis Prevention Diagnosis, and Therapy, Osteoporosis prevention, diagnosis, and therapy, 2001
- emedicinehealth.com
- ncbi.nlm.nih.gov
- mayoclinic.com
- wikipedia.org
Filed Under: Surgery
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