Osteoporosis

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WHAT HAPPENS IF U
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DEFINITION

• DISEASE CHARACTERISED BY INCREASE POROSITY OF
  BONE DUE TO DECREASED BONE MASS
• PREDISPOSE THE BONE TO FRACTURES

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TYPES

• 1) LOCALIZED
• SINGLE BONE OR REGION
• e.g. DISUSE OSTEOPOROSIS
• 2) GENERALIZED
• ENTIRE SKELETON
• PRIMARY / SECONDARY

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ETILOGY

• I ) PRIMARY
• SENILE
• POSTMENOPAUSAL
• IDIOPATHIC
• II ) SECONDARY

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ETIOLOGY OF GENERALIZED OSTEOPOROSIS
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FACTORS AFFECTING PEAK BONE MASS

• VITAMIN D RECEPTORS
• ESTROGEN RECEPTORS
• INSULIN LIKE GROWTH FACTOR 1
• PHYSICAL ACTIVITY
• MUSCLE STRENGTH
• DIET RICH IN Ca
• HORMONAL STASTUS

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PATHOGENESIS

• SENILE OSTEOPOROSIS
• ( LOW TURNOUT )
• POSTMENOPAUSAL OSTEOPOROSIS
• ( HIGH TURN OUT )

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PATHOGENESIS
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3. REDUCED PHYSICAL ACTIVITY

• MECHANICAL FORCES
• IMPORTANT STIMULI FOR BONE REMODELING

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4. GENETIC FACTORS

• VIT. D RECEPTORS
• 75 BONE MASS
• MUTATION IN VIT. D RECEPTORS
• DEC. BONE MASS

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5. Ca NUTRITIONAL STATUS

• DEC. Ca INTAKE DURING GROWTH PERIOD
• DEC. PEAK BONE MASS
• INC. RISK OF OSTEOPOROSIS

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CLINICAL FEATURES

• ASYMPTOMATIC
• BACKACHE
• LOSS OF HEIGHT
• LUMBER LORDISIS
• KYPHOSIS
• SCOLIOSIS

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MORPHOLOGY

• 1. POSTMENOPAUSAL
• INC. OSTEOCLAST ACTIVITY
• AFFECT VERTEBRAL BODY
• THIN BONE
• MICROFRACTURE, COLLAPSE
• 2. SENILE
• THIN CORTEX
• WIDE HAVERSIAN SYSTEM

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LABORATORY DIAGNOSIS

• 1. BLOOD
• S. Ca NORMAL
• S. PO4 NORMAL
• S. AP NORMAL

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2. X RAY

• USEFUL WHEN 30 40 BONE LOSS
• THIN CORTEX
• MICROFRACTURE
• VERTEBRAL DEFORMATY
• COLLAPSE

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3. DEXA BONE SCAN

• DUAL ENERGY X AY ABSORPTIOMETRY
• DETERMINE DENSITY OF ANY BONE

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4. C.T. DENSITOMETRY

• HIGHLY ACCURATE

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PREVENTION
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PREVENTION

• GENTLE EXERCISE
• GOOD DIETRY Ca
• GOOD DIETRY VIT. D
• HRT
• BISPHOSPHONATE
• AVOID SMOKIN
• AVOID EXCESS ALCOHOL

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COMPLICATIONS

• SKELETAL DEFORMITY LIKE KYPHOSIS, SCOLIOSIS
• FRACTURES OF LONG BONE
• PULMONARY EMBOLISM
• LOSS OF HEIGHT

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OSTEOPOROSIS

• OSTEOPOROSIS