Osteoporosis

Question 1

Osteoporosis

Answer 1

• bone deterioration with
  
  • reduced bone mass
  • disruption of the micro-architecture of the bone
• Results in higher risk of fractures

Question 2

DXA scan

Answer 2

• DXA is GOLD STANDARD
  
  • bone density is compared on bell curve to give
    
    • T score = comparison to young adults
    • Z score = comparison to age-matched adults
  • Osteoporosis = T score < or equal to -2.5
  • normal = -1 to 1
• ANYONE with a fragility fracture by definition has a diagnosis of OSTEOPOROSIS

Question 3

when do you not use a T score

Answer 3

• never use in children
• do not apply to pre-menopausal wome
• do not apply to men <50 years old

Question 4

when to use a Z-score

Answer 4

• Z-score = comparing BMD to a person of the same age
• useful in patients who are younger than peak bone mass
• use in pre-menopausal women (bone density is lower than would be expected
• use in men <50 years old
• Z-score < -2

Question 5

Recommendations for screening

Answer 5

• advise on

Question 6

risk factors for osteoporosis

Answer 6

• current age
• gender (f>M)
• personal hx of fracture
• glucocorticoid therapy
• smoking
• parental hx of hip fracture
• alcohol intake of 3 or more drinks/day