Osteoporosis Flashcards
What is it?
A progressive, systemic disease of the skeleton characterised by reduced bone mass and mirco-architectural deterioration of bone tissue
What happens to the bone?
It becomes fragile and susceptible to fracture
What fractures occur in trabecular bone?
Crush fractures
What fractures occur in cortical bone?
Long bone fractures
Why do women lose trabecular bone?
Because they have a decreased level of oestrogen after the menopause
What is the number definition of osteoporosis?
A standard deviation of >2.5 from the T score of a DEXA scan
What is primary osteoporosis?
Age related
What is secondary osteoporosis?
Caused by another condition or drug
Is it common?
Yes, more than 2 million women in the UK are affected and causes 180,000 fractures per year
Who does it affect?
6% of males and 18% of females, normally over the age of 50
Risk factors (11)
Age, female, low BMI, parental history, corticosteroid therapy, cushing’s, Rheumatoid arthritis, prolonged immobility, untreated menopause, 4 units alcohol per day, smoking
Signs and Symptoms (2)
*Asymptomatic until a fracture, low trauma fragility fracture usually of the vertebrae, proximal femur, distal radius, humerus and pelvis)
What bloods would you do? (4)
Calcium, Vitamin D, Phosphate, Alk Phos (normal in primary osteoporosis)
Other investigations (2)
X-ray, DEXA scan
What is the treatment? (10)
Calcium and vitamin D supplement, Bisphosphonates, Strontium Ranelate, HRT/Raloxifene, Calcitonin (reduces pain after vertebral fracture), Danosumab (regulates Osteoclast differentiation), Analgesia for fractures, physiotherapy, weight bearing exercises, alcohol and smoking cessation
