Osteoporosis overview: Difference between revisions
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==Differentiating Disease from other Conditions== | ==Differentiating Disease from other Conditions== | ||
[[Osteoporosis]] must be distinguished from [[Idiopathic transient osteoporosis of hip]], [[ | [[Osteoporosis]] must be distinguished from [[Idiopathic transient osteoporosis of hip]], [[osteomalacia]], [[scurvy]], [[osteogenesis imperfecta]], [[multiple myeloma]], [[homocystinuria]] and [[hypermetabolic resorptive osteoporosis]] which can also present with similar features. | ||
==Natural History, Complications and Prognosis== | ==Natural History, Complications and Prognosis== | ||
Revision as of 17:15, 22 July 2012
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Osteoporosis Microchapters |
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Diagnosis |
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Treatment |
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Medical Therapy |
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Case Studies |
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Osteoporosis overview On the Web |
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American Roentgen Ray Society Images of Osteoporosis overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Raviteja Guddeti, M.B.B.S.[3]
Overview
Osteoporosis is a disease of the bone characterized by a lower bone mineral density which leads to an increased risk of fracture. Pathology involves an unbalance between bone resorption and new bone formation. Aging, female gender, alcoholism, hypogondism and steroid abuse are among the primary risk factors associated with Osteoporosis. It can be prevented with lifestyle advice and medication, and preventing falls in people with known or suspected osteoporosis is an established way to prevent fractures. Bisphosphonates calcium and vitamin D supplementation form the main stay of treatment.
Pathophysiology
The pathophysiology of Osteoporosis involves an imbalance between bone resorption and bone formation. Factors that contribute to the development of Osteoporosis include advanced age, female sex and hypogonadism.
Causes
Osteoporosis is caused by imbalance between bone resorption and bone formation. The most common causes causing osteoporosis includeaging, chronic renal failure, nutritional deficiency of calcium and / or vitamin D, immobility, hyperparathyroidism, menopause and chronic glucocorticoid abuse.
Epidemiology and Demographics
Osteoporosis is a major health problem affecting 44 million male and women patients in the United States. The disease is more common in females aged over 50 years.
Risk Factors
Risk factors for Osteoporosis include both non-modifiable (e.g age, female sex etc.,) and (potentially) modifiable (smoking, alcohol etc.,).
Differentiating Disease from other Conditions
Osteoporosis must be distinguished from Idiopathic transient osteoporosis of hip, osteomalacia, scurvy, osteogenesis imperfecta, multiple myeloma, homocystinuria and hypermetabolic resorptive osteoporosis which can also present with similar features.
Natural History, Complications and Prognosis
Osteoporosis can be complicated by the development of fractures. The prognosis is good. Mortality from the disease depends on the type of fracture. The major type of fractures contributing to mortality in these patients are vertebral fractures and hip fractures.
Diagnosis
Symptoms
Osteoporosis itself has no symptoms. The disease state causes increased fragility of the bones and thus making them more prone to fractures.
Physical Examination
Osteoporosis is associated with the presence of fractures on physical examination.
Laboratory Studies
Lab tests for the diagnosis of Osteoporosis include some baseline tests like complete blood count (CBC), serum calcium, phosphate, and alkaline phosphatase and 25(OH) vitamin D as well as tests for diagnosing secondary osteoporosis, which include 24 hr serum calcium, serum protein electrophoresis and bone marrow biopsy.
Treatment
Medical therapy
Drugs, especially Bisphosphonates are the main medications in the treatment of osteoporosis. However, lifestyle changes are also emphasized. No treatment can completely reverse established Osteoporosis. Medical management can only halt the progression of the disease process.
Surgical therapy
Surgical therapy is employed for fractures caused by Osteoporosis. Vertebroplasty and Kyphoplasty are used to treat patients with vertebral compression fractures. For fractures of the hip open reduction and internal fixation is done.
References