Osteoporosis Flashcards
Define osteoprorois
Low bone density (T-score bone fragility and susceptibility to fracture
What are the causes/risk factors of osteoporosis?
Causes
Primary
• Idiopathic
• Post-menopausal
Secondary • Malignancy e.g. myeloma • Endocrinopathies e.g. Cushing’s, hyperthyroidism, primary HPT, hypogonadism • Drugs e.g. corticosteroids, heparin • Rheumatoid arthritis • Malabsorption • Primary biliary cirrhosis
Risk Factors • Older age • Family history • Female • Post menopause • Prolonged immobilisation • Smoking • Alcohol abuse • Steroids • Low BMI • Low calcium intake
What are the symptoms of osteoporosis?
• Asymptomatic
• Back pain
• Fractures (NOF, vertebral -> loss
of height, stooping, Colles’)
What are the signs of osteoporosis?
- Kyphosis
* Tenderness
What investigations are carried out for osteoporosis?
• Bloods
- Normal Ca2+, PO3, PTH, ALP in primary osteoporosis
• X-ray – identify fractures, radiolucency, cortical thinning, biconcave vertebrae
• Dual energy X-ray absorptiometry (DEXA) – T-score
What is the management for osteoporosis?
Primary prevention • Regular weight bearing exercise • Calcium rich diet • Smoking cessation • Alcohol reduction • HRT • Prophylactic bisphosphonates if on steroids
Osteopenia (-1 to -2.5)
• Calcium and vitamin D (ergocalciferol) supplements
Osteoporosis • Treat the underlying cause! • Bisphosphonates e.g. alendronate • Strontium ranelate • Calcitonin • SERMs e.g. raloxifene • Denosumab (monoclonal antibody) • HRT • Teriparatide (synthetic PTH)
What are the complications of osteoporosis?
- Pain
- Disability
- Fractures
