Osteoporosis

Osteoporosis is a reduction in bone mass per unit volume. Osteoporosis leads to literally abnormally porous bone that is more compressible like a sponge, than dense like a brick. This disorder of the skeleton weakens the bone causing an increase in the risk for breaking bones (bone fracture). The fracture can be either in the form of cracking (as in a hip fracture), or collapsing (as in a compression fracture of the vertebra of the spine). The spine, hips, and wrists are common areas of bone fractures from osteoporosis, although osteoporosis-related fractures can also occur in almost any skeletal bone.

A = NORMAL BONE
B = OSTEOPOROTIC BONE

OSTEOPOROSIS

Primary:
Type I Postmenopausal osteoporosis (50 to 75 years) due to decrease oestrogen. Affects spine and wrist

Type 2 Seniele osteoporosis (70years and above). Affects hip and spine

Induced by : smoking, alcohol, less intake of calcium, white ras, less activity,thin

Secondary:
caused by: hyperthyroid,hyperparathyroid,
corticosteroid, multiple myeloma, malnutrition,
hypogonadism, chronic renal failure,
medications

Symptoms

Osteoporosis is a silent disease, it can be present without any symptoms for decades, because osteoporosis doesn't cause symptoms unless bone fractures.

The symptoms of generalizes of oteoporosis include chronic intermitten back pain (which is probably related to repeated microscopic fractures)


Risk factors

Radiographic Diagnosis
The radiographic features include a generelized rarefaction of all bones (but most marked in cancellous bone), thin cortices, and evidence of deformity, particularly in vertebral bodies.

A relatively recent development is bone densiometry to quantitate accurately the bone mineral density of a given patient. The current method of choice is dual energy X-ray absorptiometry (DEXA)

Dual energy X-ray absorptiometry (DXA, formerly DEXA) is considered the gold standard for the diagnosis of osteoporosis. Osteoporosis is diagnosed when the bone mineral density is less than or equal to 2.5 standard deviations below that of a young adult reference population. This is translated as a T-score. The World Health Organization has established the following diagnostic guidelines:

• T-score -1.0 or greater is "normal"
• T-score between -1.0 and -2.5 is "low bone mass" (or "osteopenia")
• T-score -2.5 or below is osteoporosis

When there has also been an osteoporotic fracture (also termed "low trauma-fracture" or "fragility fracture"), defined as one that occurs as a result of a fall from a standing height, the term "severe or established" osteoporosis is used.

The International Society for Clinical Densitometry takes the position that a diagnosis of osteoporosis in men under 50 years of age should not be made on the basis of densitometric criteria alone. It also states that for pre-menopausal women, Z-scores (comparison with age group rather than peak bone mass) rather than T-scores should be used, and that the diagnosis of osteoporosis in such women also should not be made on the basis of densitometric criteria alone.

Treatment

1. Medication

Bisphosphonates are the main pharmacological measures for treatment. However, newer drugs have appeared in the 1990s, such as teriparatide and strontium ranelate.

Estrogen replacement therapy remains a good treatment for prevention of osteoporosis but, at this time, is not recommended unless there are other indications for its use as well. There is uncertainty and controversy about whether estrogen should be recommended in women in the first decade after the menopause.

Some SERMs such as raloxifene (Evista), act on the bone by slowing bone resorption by the osteoclasts. Others, such as Femarelle (DT56a), achieve a significant effect by stimulating osteoblast activity thus inducing new bone formation.

2. Nutrition

Calcium, Vitamin D

3. Exercise