Osteoporosis

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Osteoporosis (outline of chapter)

Introduction

Causes of osteoporosis

Signs and symptoms of osteoporosis

Diagnostic tests for osteoporosis

Treatment of osteoporosis

[edit] Osteoporosis

Introduction:

Osteoporosis is a disease of the skeletal system where the bone mass is reduced, there is a deterioration of the micro-architecture of the bone and an associated increased fracture risk. Bone density can be measured with the help of bone densitometry and values are found as indicated in the table below.

These values are standard deviations and are compared to 35-year old normal controls matched for sex and race.

Bone density classification
Densitometry score:	Comments:
above -1	normal bone density
-1 to -2.5	osteopenia, which means there is a certain lack of calcium in the bones
less than -2.5	osteoporosis is established

So, if the bone density is less than 2 1/2 standard deviations below the comparative value of a 35-year old normal control, then this is a patient who has osteoporosis (see table above).

Here are a few facts about bone growth and osteoporosis (see Ref. 1 and 2):

[edit] Some facts about osteoporosis and bone growth Peak bone growth has been achieved at the age of 30 and from then on there is a loss of 1/2 to 1% of bone mass per year. In women there is a 3 to 5 year accelerated loss of bone mass after menopause. There is a mortality increase of 20% in the first year after a hip fracture. Compression fractures of the vertebral bodies with osteoporosis lead to a deformity called kyphosis (permanent forward bending mostly of the thoracic spine), which can lead to chronic pain from impinging of the costal margin on the pelvic bone and also is hard on the lungs and the heart circulation. Chronic disability from osteoporosis leads often to a loss of independence, earlier nursing home admissions and premature death due to complications from fractures or from coexisting medical disease.

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References:

1. ABC of rheumatology, second edition, edited by Michael L. Snaith M.D., BMJ Books, 1999.

2. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 57.

3. B. Sears: "The age-free zone".Regan Books, Harper Collins, 2000.

4. B. Sears: "Zone perfect meals in minutes". Regan Books, Harper Collins, 1997.

5. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders

6. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

7. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier