Week 4: Bone disease

Question 1

On which parts of the body are DEXA scans performed

Answer 1

Neck of femur
Lumbar spine
Wrist

Question 2

What DEXA score indicates osteoporosis

Answer 2

-2.5 SD

Question 3

Describe difference between osteoporosis and osteomalacia.

Can use the wall of bricks analogy to explain

Answer 3

OSTEOPOROSIS
Proportional reduction in solid components

(Wall is made of less bricks)

OSTEOMALACIA
More loss of mineralised component. So relatively more osteoid (unmineralised)

(Wall is made of same number of bricks but poorer quality)

Question 4

Which 4 endocrine problems can cause secondary osteoporosis

Answer 4

1. Hyper-PTH
2. Hyper-thyroidism
3. Cushing’s (high cortisol)
4. Hypogonadism

Question 5

3 Features of osteomalacia on xray

Answer 5

1. cupped epiphyses
2. loosers zones (unmineralised bone areas) in lesser trochanter, pubic rami
3. rachitic rosary (expansion of anterior ribs at costochondral junction)

Question 6

Treatment for osteoporosis

Answer 6

1. Increase calcium and vit D intake

2. Bisphophonates

Question 7

Treatment for osteomalacia

Answer 7

1. Increase Vit D intake
2. Colecalciferol
3. Ergocalciferol