Osteoporosis Flashcards
Define:
Reduced bone density of >2.5 than the T score.
THIS IS REDUCED BONE MASS.
Aetiology:
Primary - if <50 years –> idiopathic + post menopause
Secondary - ME DR G
- Malignancy - myleoma and metastatic carcinoma
- Endocrine -Cushing’s disease, Thyrotoxicosis Primary hyperparathyroidism, Hypogonadism
Drugs - corticosteroids, heparin
Rheumatological - rheumatoid arthritis, ankylosing spondylitis
Gastrointestinal:
• Malabsorption (e.g. coeliac disease, partial gastrectomy)
• Liver disease (e.g. primary biliary cirrhosis)
• Anorexia
Risk factors:
SHATTERED
Smoking/steroid use
Hyperparathyroidosis/calcuria and thyroidism
Alcohol/age
Thin (BMI<22) - or lack of exercise
Testosterone low
Early menopause/ late menarche
Renal or liver failure
Erosive/ inflammatory bone disorders
Dietary deficiency of calcium and malabsorption
Symptoms:
Usually none till there are fractures
Common fracture sites:
- Colle’s fracture
- Neck of the femur
- Vertebral fractures
Signs:
Usually none till there are fractures.
Bone tenderness on percussion
Thoracic Kyphosis
Severe pain when hip is flexed and internally rotated
Epidemiology:
Common
If <50 yrs:
1/3 women
1/12 men
More common in caucasians than Afro-Caribbean
Investigations:
Bloods:
-Calcium, ALP and phosphate = NORMAL
X-ray:
- will not show anything until there is >30% loss
- Biconcave vertebrae
- Crush fractures
Isotope bone scans
DEXA SCAN
What is the difference between a Z score and a T score?
T score is how many standard deviations the bone mineral density is above or below a young normal mean bone density.
Z score is how many standard deviations the bone mineral density above or below than an age matched mean bone density.