Osteoperosis

Question 1

Definition/Description

Answer 1

There are two types of osteoporosis: primary and secondary.

Primary osteoporosis is unrelated to other diseases or conditions and is the more common of the two. It is most common in postmenopausal women or older men, but can occur at any age. In cases of primary osteoporosis, either the condition is caused by age-related bone loss (sometimes called senile osteoporosis) or the cause is unknown (idiopathic osteoporosis).

In cases of secondary osteoporosis, the loss of bone mass is caused by certain lifestyle behaviors, diseases, or medications. The most common causes of secondary osteoporosis in men include exposure to glucocorticoid medications, hypogonadism (low levels of testosterone), alcohol abuse, smoking, gastrointestinal disease, hypercalciuria, and immobilization.

Question 2

Characteristics/Clinical Presentation

Answer 2

Osteoporosis is often referred to as a silent disease because there are no early clinical signs or symptoms. Frequently, no symptoms are present until bone loss is advanced enough to result in a fracture. Common locations of fracture include: proximal femur, vertebrae, hip, pelvis, proximal humerus, distal radius, and tibia. Proximal femur and vertebrae are the two most common sites.

Therefore, constant mild to severe back pain may be a concern when there is no history of injury or falls. Hip fractures are usually not detected until a fall has occurred. Because of the lack of early symptoms, those at risk are highly suggested to get routine bone scans. Many individuals will develop secondary orthopedic problems related to postural changes, fractures, and a general decrease in physical conditioning that often accompanies the disease.

A common presentation of an individual with osteoporosis may be a Caucasian female, 65 years or older, with a thin body type.

Question 3

Clinical Signs and Symptoms

Answer 3

Back pain: Episodic, acute low thoracic/high lumbar pain
Compression fracture of the spine 
Bone fractures
Decrease in height 
Kyphosis
Dowager’s hump
Decreased activity tolerance
Early satiety

Question 4

Bone Density Test

Answer 4

The most common test used is a bone density test, which is the only test that can detect osteoporosis before a fracture occurs. There are two types of bone density tests: Central DXA and Screening Tests.

. Central DXA uses a dual energy absorptiometry machine to test the bone density of the hip and spine. If testing can’t be done to the hip and spine then it is recommended to test the radius of the forearm. Central DXA is the preferred method because it measures bone density at the hip and spine where bone loss occurs most rapidly