Osteoporosis

Question 1

Define osteoporosis.

Answer 1

Osteoporosis is a complex skeletal disease characterised by low bone density and micro-architectural defects in bone tissue, resulting in increased bone fragility and susceptibility to fracture.

Question 2

Explain the aetiology/risk factors of osteoporosis.

Answer 2

Prior fragility fracture
Female sex
White ancestry
Older age (>50 years for women and >65 years for men)
Low BMI
Postmenopause
Secondary amenorrhoea
Primary hypogonadism
Smoking
Excessive alcohol use
Prolonged immobilisation
Low calcium intake
Vitamin D deficiency
Glucocorticoid excess
Corticosteroid use

Question 3

Summarise the epidemiology of osteoporosis.

Answer 3

In the UK and Europe, fractures caused by osteoporosis affect 1 in 2 women and 1 in 5 men aged >50 years.

Question 4

Recognise the presenting symptoms of osteoporosis. Recognise the signs of osteoporosis on physical examination.

Answer 4

Back pain
Kyphosis
Impaired vision
Impaired gait, imbalance, and lower-extremity weakness
Vertebral tenderness

Question 5

Identify appropriate investigations for osteoporosis and interpret the results.

Answer 5

DXA scan
Serum alkaline phosphatase
Serum calcium
Serum 25-hydroxy vitamin D
Serum parathyroid hormone
Thyroid function tests