Osteoporosis – Dr.Murtaza Adeeb
Definition:
Osteoporosis is defined by the WHO as a bone mineral density that is 2.5 standard deviations or more below the peak bone mass as measured by a DEXA scan.
This definition is even confusing for doctors.so in layman’s terms osteoporosis is softening of the bones due to hormonal changes particularly in menopausal women and also due to ageing and certain medication in both women and men.
There are 2 kinds
- Primary osteoporosis
Type 1:
Post menopausal-Women after menopause.
Type 2:
Senile-After 75 yrs in both women and men
- Secondary osteoporosis
As a result of medication or in certain medical conditions.
Prevalence:
- 200 million worldwide.
- High risk of fractures.
- 1in 3 women and 1 in 5 men over 50 yrs experience an osteoporotic fracture.
- Mortality with osteoporotic fracture is 15 to 20 % .similar to stroke or breast cancer.
Symptoms:
- Back pain
- Generalised bone pain
- Fracture with less than expected trauma. usually first presentation. wrist, hip and spine fractures common.
Diagnosis:
- Measuring bone mass
- DEXA scan
- Quantitative CT scan
- Ultrasound
- Predicting fracture risk
- Fracture risk assessment tool (FRAX)
Management:
- Lifestyle modification:
- Weight bearing, aerobic and resistance exercises
- Therapeutic options
- Bisphosphonates
- Calcitonin
- HRT
- Teriparatide
- Vit D and calcium.
