osteoporotic fractures Flashcards
1
Q
what is osteoporosis?
A
a condition where bones gradually decrease in bone mineral density, thus increasing the likelihood of fragility fractures
2
Q
what are fragility fractures?
A
fractures that occur as a result of mechanical forces which would not usually lead to a fracture
3
Q
what is one of the most common sites of osteoporotic fractures?
A
spine (vertebra)
4
Q
how do pts with osteoporotic vertebral fractures typically present with?
A
- asymptomatic: incidental finding on XR
- acute back pain
- breathing difficulties: changes in shape and length of vertebrae leading to compression of organs
- GI problems: due to compression of abdominal organs
- minority of pts: hx fall/trauma
5
Q
what are the risk factors for osteoporotic fractures?
A
- advancing age
- post-menopausal women
- previous hx of fragility #
- frequent/prolonged used of glucocorticoids
- hx falls
- fam hx hip #
- alternative causes of 2˚ osteoporosis e.g. Cushing’s disease, hyperthyroidism, chronic renal disease
- low BMI (<18.5)
- tobacco smoking
- high alcohol intake: >14 units women, >21 units men
6
Q
what are the signs for osteoporotic vertebral fractures?
A
- loss of height
- kyphosis
- localised tenderness on palpation of spinous processes at the # site
7
Q
what are the ix done for osteoporotic vertebral fractures?
A
x-ray of the spine
- may show wedging of the vertebra due to compression of the bone
- may show old #s (sclerotic appearance)
8
Q
what other ix could be helpful for osteoporotic vertebral fractures?
A
- CT spine (detailed view of bone structure, can visualise extent/features of # more clearly)
- MRI spine (for differentiating osteoporotic # from those caused by other pathology e.g. tumour)
9
Q
what should be considered to assess the likelihood of future fractures?
A
- risk factors
- DEXA scan
- FRAX or QFracture tool to estimate 10 year risk of fracture
