Osteoporosis Flashcards

1
Q

Define:

A

Reduced bone density of >2.5 than the T score.

THIS IS REDUCED BONE MASS.

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2
Q

Aetiology:

A

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

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3
Q

Risk factors:

A

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

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4
Q

Symptoms:

A

Usually none till there are fractures

Common fracture sites:

  • Colle’s fracture
  • Neck of the femur
  • Vertebral fractures
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5
Q

Signs:

A

Usually none till there are fractures.

Bone tenderness on percussion

Thoracic Kyphosis

Severe pain when hip is flexed and internally rotated

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6
Q

Epidemiology:

A

Common

If <50 yrs:
1/3 women
1/12 men

More common in caucasians than Afro-Caribbean

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7
Q

Investigations:

A

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

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8
Q

What is the difference between a Z score and a T score?

A

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.

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