Differentiating Osteoporosis from other diseases
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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 must be differentiated from other diseases include: idiopathic transient osteoporosis of hip, osteomalacia, scurvy, osteogenesis imperfecta, multiple myeloma, homocystinuria, and hypermetabolic resorptive osteoporosis; which can all present with some similar features, too.
Differentiating osteoporosis from other diseases
- Idiopathic transient osteoporosis of hip: primarily, it is thought to be seen most often in women during the third trimester of pregnancy; but it described also in middle aged men. Acute hip pain is the main characteristic of the disease; totally, self-limited after 6-8 months. Sometimes it may be explained as early or benign avascular necrosis (AVN). Sub-chondoral cortical loss and diffuse osteopenia of the femoral head and neck are the pathognomonic features. Treatment includes joint protection, limited weight bearing, and NSAIDs. [1]
- Osteomalacia - caused by deficiency of vitamin D in adults. There is defective mineralization of newly formed bone. Diffuse bone pain, fatigue and fractures are the common symptoms. It can progress to osteoporosis.
- Scurvy - the biosynthesis of collagen is defective due to vitamiin C deficiency. New bone formation is prevented and the old bone becomes brittle due to lack and poor quality of collagen. Treatment is vitamin C replacement.
- Osteogenesis imperfecta - caused by a defect in collagen and the improper functioning of osteoblasts. Short stature, scoliosis, tooth defects, hearing defects and propensity for fractures are the main clinical features.
- Multiple myeloma - this is a malignant tumor of the plasma cells. It accounts for 40% of all bone tumors. Diffuse bone pain and tenderness are common. It also forms osteolytic lesions on the bones. The prognosis is poor. Chemotherapy is the main stay of treatment.
- Homocystinuria - is an autosomal recessive inherited disorder that affects the metabolism of the amino acid methionine. Failure to thrive, visual problems and musculoskeletal problems are the major presentations. There is not a cure.