Osteoporosis (brief)

Question 1

How common is it?

Answer 1

Prevalence 2% at 50, to 50% at 80 years of age.

Question 2

Who does it affect?

Answer 2

↑ with age.

Woman are at greater risk, decrease in oestrogen production at the menopause, which accelerates bone loss.

Question 3

What causes it?

Answer 3

Result of an imbalance in the normal process of bone remodelling by osteoclasts and osteoblasts. Results in decreased bone mineral density, and changes in bone composition, architecture size, geometry.

Question 4

What risk factors are there?

Answer 4

There are risk factors that affect bone strength, ones that reduce bone mineral density (BMD) include: Endocrine disease, GI conditions that cause malabsorption, CKD, chronic liver disease, COPD, menopause, immobility, BMI<18.5.

Ones that don’t effect BMD include: Age, oral corticosteroids, smoking, alcohol, previous fragility fractures, rheumatological conditions, parental Hx of hip fracture.

Question 5

How does it present?

Answer 5

Osteoporosis itself is asymptomatic and often remains undiagnosed until a fragility fracture occurs.

Question 6

Signs on examination?

Answer 6

Likely none

Question 7

Investigations

Answer 7

DEXA bone scan (duel beam X ray). >2.5SDs below the mean density of bone classifies you as osteoporotic.

Question 8

Treatment

Answer 8

Bisphosphonate (e.g. alendronate). Calcium if they need it along with vitamin D.