OSTEOPOROSIS
By: Brenda Fenton
What is Osteoporosis?
DEFINITION:
o A bone disease where bone density decreases
o Bones are weak and brittle (thin)
o Bones become very easy to break
o Ambulation is difficult
EXPLANATION:
o A lack of calcium is the most likely cause
o Restricting food intake and being underweight increases the risk
o Age
o Estrogen deficiency (in women)
o Low Calcium and Vitamin D intake Reasons for
o Lack of exercise osteoporosis to
o Genetics occur
o Medical conditions
o Lifestyle
Osteopenia vs Osteoporosis
Epidemiology
Population
o 200 million women worldwide
o 50 million men worldwide
o In the United States, 10 million adults are affected (80% women)
o In the US, about 1.5 million fractures each year are from osteoporosis
Age
o Typically 50 years and older
o Women after menopause
o Bone loss increases after 35
Culture
o Caucasian and Asian cultures experience it more widely
o However osteoporosis can affect anyone
Incidence
Morbidity
o Increased risk of fractures
o For example fragility, vertebral, hip
o Only 33% of women who have a hip fracture can go back to independent living
Mortality Rate
o Osteoporosis increases mortality risk, it is higher in men
o Risk of mortality after a hip fracture extends for five years
Area
o 39.5% of Africa’s population has osteoporosis
o Osteoporosis is diagnosed more in developing countries (22.1% of cases)
o 14.5% of cases in developed countries
Etiology
Osteoporosis is caused when too much bone mass is lost. The change in structure of bone tissue leads to symptoms and a
diagnosis.
o Usually, bone remodeling occurs: break down old bone and replace with new bone
o In osteoporosis, more bone is broken down than replaced
o Osteoclasts: break down bone tissue
o Osteoblasts: build new bone
o There is an imbalance; there are more active osteoclasts than osteoblasts
o Example: estrogen would usually slow down natural breakdown of bone, lack of estrogen causes osteoporosis
Pathogenesis
o Aging
o Estrogen deficiency
o Prolonged immobilization
o Hormone imbalance (PTH and cortisol)
o Nutritional deficiencies (vitamin D)
o Genetics
Dx
o Bone density test (BMD)
o Measures amount of bone mineral in a bone
o DXA scan uses low-level X-rays to asses bone density
o Scanner passes over body while pt lies down o CT scan
o The test is commonly done overtop the hip and spine o US
o T-score: compares bone density to healthy adult
o Normal density: -1 to +1
o Osteoporosis density: <-2.5
o Physical exam
o Checks for loss of Ht and Wt
o Change in posture
o Balance
o Muscle strength
DXA scan
S/S
o Signs
o Receding gums
o Weak grip strength
o Brittle finger or toenails
o Loss of Ht
o Stooped posture
o Fractures (that occur frequently)
o Symptoms
o Back pain
o Mobility changes
o Pain or weakness in thigh, hip, groin, joints
Rx
o Medications
o Biphosphonates: slow bone breakdown (alendronate)
o SERMs: reduce fracture risk by increasing bone density
(hormone therapy)
o Vertebroplasty: inject cement into a broken spinal bone
o Common procedure to treat and injury caused by
osteoporosis
o It is a compression fracture
o Lifestyle changes
o Diet (limiting alcohol and smoking)
o Exercise
o Fall prevention
RESOURCES
https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-
20351968
https://www.niams.nih.gov/health-topics/osteoporosis/diagnosis-treatment-and-steps-to-
take#:~:text=Bone%20density%20measurement%20by%20DXA,make%20it%20easier%20f
or%20screening.
https://www.endocrine.org/patient-engagement/endocrine-library/osteoporosis-treatment
https://www.niams.nih.gov/health-topics/osteoporosis
