Musculoskeletal Osteoporosis and Fractures (Exam 4) Flashcards
Gender and Bone Mass
Women experience greater bone loss in early postmenopausal years
Women have a lower peak density so they reach the fracture threshold earlier
By age the 30 the amount of bone reabsorbed by osteoclasts is __________ than bone formed by osteoblasts
greater
Osteoporosis Definition
Bone mineral density 2.5 standard deviations below peak bone mass
Low bone density
Osteoporosis is measured with
Dexas scan
Results reported in a T-score
Normal T-score
-1 or greater
Osteopenia T score
-1 and -2.5
Osteoporosis and Severe Osteoporosis
< -2.5
It is severe when patient has history of fragility fracture (Patient fell and broke a bone)
Osteopenia
Thinning of the trabecular matrix of the bone before osteoporosis
T score( -1) - (-2.5)
Osteoporosis
Porous bone
Common yet serious disease
Osteoporosis is characterized by
Low bone density and structural deterioration of the bone
ACTUAL BREAKS in trabecular matriz have occurred
Osteoporosis most commonly appears in what bones?
Hips
Vertebrae
Wrists
Osteoporosis Characterisitics
Low bone mass
Micro - architectural deterioration (microscopic fractures)
Increase bone fragility leading to weak bones and fractures
Osteoporosis: Major RF’s
Aging (bone break down after 30)
Female (post menopausal women)
Caucasians
History fracture as adult
Family history and genetics (1 degree)
Body weight < 127
Smoking (bones cannot heal)
Alcohol use
Long term steroid use (inhibits osteoblast function)
Osteoporosis: Minor RF’s
Thin small frame
Lack of weight bearing exercises
Lack of calcium and or vitamin D
Eating disorders and gastric bypass surgery
Lack of estrogen/testosterone
Excessive Caffeine consumption
Osteoporosis Pathogenesis
Increased bone resorption (Breakdown) (Osteoclast activity increased)
Decrease bone formations (Osteoblast (builderd) activity decreased)
Problem can be: Failure to make new bone (Osteoblasts) Too much bone resorption (Osteoclasts)
Osteoclasts activity is increased
Osteoblast activity is decreased
Osteoporosis: Clinical Manifestations
Early and Late
Early: None
Late:
Fractures
Pain
Loss of height
Stooped posture (Kyphosis)
Complications of Osteoporosis: Hip Fractures
Hip fractures linked to increased risk of mortality.
2.8-4x greater risk of death
More common in women greater than 65
Dependent living is lost
Most common location of hip fracture related to osteoporosis
Proximal third of the femur
Hip fracture: Clinical Presentation
Sudden onset of hip pain before or after a fall
Inability to walk
Severe groin pain
Tenderness
Affected leg is externally rotated and shortened
Goal of Pharmacotherapy: Osteoporosis
Reduce fractures
Primary Prevention of Osteoporosis
Calcium supps
Vitamin D supps
Primary Treatment of Osteoporosis
Promote bone formation
Decrease bone resorption (most common)
Fractures
Any break in the continuity of bone that occurs when more stress is placed on the bone that is able to absorb
Fractures Causes
Traumatic (Fall) (Massive muscle contraction)
Fatigue (Repeated prolonged stress)
Pathologic (weakened bone in elderly) (Bone tumor) (Infection)
