osteoporosis Flashcards
what is osteoporosis?
A skeletal condition characterised by low bone mass, deterioration of bone tissue, and disruption of bone architecture that leads to compromised bone strength and an increased risk of fracture
what are the non modifiable risk factors for osteoporosis?
- Advanced age (>65 years)
- Female gender
- Caucasian or south Asians
- Family history of osteoporosis-genetic
- History of low trauma fracture e.g fall from
standing height or less, at walking speed or less.
what are the modifiable risk factors for osteoporosis?
- low body weight (58kg or BMI <21)
- premature menopause (<45)
- calcium/vit D deficiency
- inadequate physical activity
- cigarette smoking
- excessive alcohol intake (>3 drinks/day)
- iatrogenic e.g corticosteroids, aromatase inhibitors
how is diagnosis for osteoporosis made?
dual energy x ray absorptiometry (DEXA) of the lumar spine and hip is gold standard
what is the T score and how is it used to make a diagnosis ?
T score is the number of SDs from the mean bone density of a person of the same gender at the age of peak density (25yrs)
T-score minus 2.5 or less = osteoporosis
Normal BMD = T-score ≥ −1
Osteopenia = T-score between −1 and −2.5
what is the z score and how is it used to make a diagnosis?
The Z-score is a comparison of the patient’s BMD with an age & gender-matched population.
Z score
how is osteoporosis treated?
vit D and potentially calcium supplementation
as well as
1st line: oral bisphosphonates, or IV if oral isnt tolerated
2nd line: Denosumab or teriparatide
what are some secondary causes of osteoporosis?
- coeliac
- eating disorders
- hyperparathyroidism
- hyperthyroidism
- multiple myeloma
how is osteopenia treated?
focus is risk modification
- weight bearing exercises
- vit D3 supplements
- limit alcohol
- smoking cessation
