Osteoporosis - Signs and symptoms

Symptoms & signs :

Back pain, decrease in height & mobility, postural deformities as kyphotic dowager's hump. Consequent pulmonary gastrointestinal and bladder dysfunction etc.

Vertebral bone:

Is especially vulnerable to fractures as bone loss begins as early as 20yrs of age.
Back ache is major clinical symptom of vertebral compression fracture.
Pain with a fracture is acute and subsides over 2 to 3 months but lingers as chronic low back pain due to increasing lumbar lardosis. The pain subsides with in 6 months unless multiple fractures produce a picture of constant pain.
App 50% of women > 65 yrs have spinal compression fractures about 2/3 are clinically unrecognized. Each complete compression fracture causes the loss of app 1 cm in ht.
The average untreated post menopausal women can expect to shrink 2.5inc .
The common sites for vertebral fractures are the 12th thorasic and the first three lumbar vertebrae. These physical changes have a negative impact on body image and self esteem.

Colle’s fracture:
There is 10 fold increase in distal forearm fracture in as the age progress from age 35 to 60 yrs. Women have a 15% lifetime risk of fore arm fractures.
Colle's fractures are the most common fractures among white women until age of 75, when hip fractures more common.

Head of femur fractures :

The incidence of hip fractures increase with age from 0.3/1000 in 45 yrs to 20/1000 in 85yrs.
White women have 14% lifetime risk and black women6%.
The fractures carries an increase risk of morbidity and mortality 25% of pts over the age of 50 yrs with hip fractures die due to fracture or its complications.
Like surgical, embolic, cardiopulmonary with in 1yr. Prevention of fractures have only minor impact on longetivity as mortality is mostly due to underlying conditions.

Toothloss :
Oral alveolar bone loss which can lead to loss of teeth strongly correlated with osteoporosis and the salutary effect of estrogen on skeletal bone mass.
Tooth loss also correlated with the use of cigarettes, a recognised contributor to bone loss. Individuals at an increased risk for fractures can be identified by a careful history.

Changes of bone remodeling
Pathophysiology
Signs and symptoms
Risk factors and investigations
Investigations
Diagnostic tests and biochemical markers
Hormonal treatment
Estrogen modulators, calcium
Vitamin D
Bisphosphonates
Calcitonin, Fluoride, Tibolone
Prevention