Risk factors:
-Previous history of fragility fractures,
-Family history of fragility fractures in close relatives,
-Smoking,
-Body thin and small framed,
-Family history of osteoporosis,
-Amenorrhea (hypoestrogenism) before menopause,
-Lifelong defective calcium intake,
-Use of bone loosing medications,
-Sedentary lifestyle,
-Excessive use of alcohol etc.
Investigations :
Measuring bone density:
There is a 50% to 100% increase in fractures risk for each s.d.(significant difference) decline in bone mass. App 0.1/cm bone mass. Measurement of lower bone mass in the hip is more predictive.
Reasons to measure bone mass:
To make decisions regarding hormone therapy, to assess response to therapy, to assess bone mass in pts on long term glucocorticoids, throid hormone, anticonvulsants,heparin etc, to diagnose and assess severity of osteoporosis.
Single photon single energy x ray absorptiometry and usg are cost effective , measure the bone loss at heal and radius and accuratly assess future fracture risk. These measures correlate with vertebral bone density.
Standard x rays donot provide an early assessment of fracture risk. 30 to 40% bone must be lost before radiographic changes become apparent.
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
-Previous history of fragility fractures,
-Family history of fragility fractures in close relatives,
-Smoking,
-Body thin and small framed,
-Family history of osteoporosis,
-Amenorrhea (hypoestrogenism) before menopause,
-Lifelong defective calcium intake,
-Use of bone loosing medications,
-Sedentary lifestyle,
-Excessive use of alcohol etc.
Investigations :
Measuring bone density:
There is a 50% to 100% increase in fractures risk for each s.d.(significant difference) decline in bone mass. App 0.1/cm bone mass. Measurement of lower bone mass in the hip is more predictive.
Reasons to measure bone mass:
To make decisions regarding hormone therapy, to assess response to therapy, to assess bone mass in pts on long term glucocorticoids, throid hormone, anticonvulsants,heparin etc, to diagnose and assess severity of osteoporosis.
Single photon single energy x ray absorptiometry and usg are cost effective , measure the bone loss at heal and radius and accuratly assess future fracture risk. These measures correlate with vertebral bone density.
Standard x rays donot provide an early assessment of fracture risk. 30 to 40% bone must be lost before radiographic changes become apparent.
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
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