WEEK NINE Flashcards
Define osteoporosis?
Osteoporosis is characterised by a reduction in bone mass and skeletal strength, and has not symptoms
Define osteoarthritis?
Osteoarthritis is characterised by progressive joint pain and mobility impairment associated with the loss of cartilage and involvement of the underlying bone
When to undertake screening for osteoporosis?
- Early menopause
- Men with low testosterone levels
- Frequent internal corticosteroid use
- Individuals with one or more fractures
- > 70 yrs of age
- Those considered at risk – Screening >50 yrs of age, every 2 years
- Individuals with malabsorption syndromes, overactive thyroid conditions
Diagnosis of osteoporosis?
Medical history Physical examination Bone density test Risk assessment for fractures Laboratory tests Normal 25-hydroxy Vitamin D >50 nmol/L Severe deficiency >12.5 nmol/L Other tests - x-rays, vertebral fracture assessments (VFAs), and bone scans
Screening and diagnosing osteoarthritis?
Physical assessment
Xray
Blood tests - ESR, rheumatoid factor
Synovial fluid Aspiration from Joint
Short term management of osteoporosis?
Surgery
-Interdisciplinary team meeting to assess and review needs
- Review of Activities of daily living
- ACAT assessment/Falls risk assessment/Depression screening
- Discharge considerations
- Medication/diet/rehabilitation review and planning
- Self management plan
- Smoking cessation plan
Impact of disease on quality of life?
Depression Burden Pain Anxiety Loss of control Role change Employment status Financial status Helplessness Anger
Long term management of osteoporosis?
Team management Rheumatologist / orthopaedic surgeon / GP Review by other team members on a regular basis Physiotherapist Dietician Occupational therapist Podiatrist Orthotist
Self managment of osteoarthritis and osteoporosis?
Exercises and resistance training
keep joints mobile
Increase strength in bones
Improve balance to lower the risk of falling
Improve mood / assists with weight loss or gain
Increases muscle strength
Protective equipment for joints
Changing occupational habits
Pain relief with non pharmacological interventions
Psychosocial management
Objective of fall prevention model of care?
To create a robust and healthy population
Apply falls prevention interventions
Optimise care pathways and communication
Support research into practice
How is Osteoporosis characterised or defined?
Osteoporosis is characterised by a reduction in bone mass and skeletal strength, and has not symptoms
What are the clinical manifestations consistent with osteoporosis in this patient?
Increasing fractures and height reduction
How is osteoporosis diagnosed?
Physical assessment, Medical history, risk assessment for fractures, physical examination of height, blood tests for vit D levels, x-ray, and bone density scan,
What medications are essential for managing osteoporosis?
Vitamin D- build bone strength (Calcitonin also provides pain relief). Calcium supplements if needed (calcium carbonate, calcium citrate – more expensive, but absorption is easier). Paracetamol – analgesia relief for stronger pain, 4 grams only per day over 24 hours. Biphosphanate – (Fosamax) reduces bone loss but is painful after swallowing – sit up for 30 minutes post medication.
What strategies would someone with osteoporosis need to consider in order to enable them to self-manage their condition?
Take Vitamin D- go into sunlight 4-6 times a week for 5 – 20 minutes, Exercise for 30 minutes a day and do weight bearing exercise, Limit alcohol and caffeine use, discontinue smoking
