Osteoporosis Flashcards
(31 cards)
Bone fxs
Rigid framework for the body
Calcium pool that is interchangeable
Osteoblasts
Build bone
Osteoclasts
Break down bone
Basic Mechanisms responsible for development of primary osteoporosis
- You don’t develop appropriate levels while growing
2. Accelerated bone loss after peak bone mass is achieved
Fraction of risk for fracture in postmenopausal women
2/3
Main factor affecting peak bone mass
Genetic makeup
Rate of bone loss affected by…
Nutrition
Behavior
Medications
Non-controllable Risks
Female gender Small frame Advanced age Hormone levels Genetics Predisposing medical conditions
Controllable Risks
Cigarette smoking Excessive alcohol intake Inactive lifestyle Excessive caffeine intake Lack of WB exercise Poor health Low weight Calcium-poor diet Low Vitamin D levels
In what kind of bone?
Cancellous bone
Peak bone mass
Mid-20s
Plateaus for ~10 years
Followed by net bone loss of 0.3-0.5% per year
> 60 years old… Osteoblastic activity drops off
Primary
Most common in post-menopausal women and older men
Type I
Type II
Ideopathic
Ideopathic
Uncommon
Occurs in children and young adults
Normal gonadal function
Both sexes
Type I (Post-menopausal)
Age 51-75 - increase osteoclasts
6xs more common in women
Associated with vertebral crush fractures and Colles fractures (distal radius)
Type II (Senile)
Older men more common
Normal aging
Gradual decline in # and activity of osteoblasts
Fractures of trabecular and cortical bones: femoral neck, vertebrae, wrist, proximal humerus, tibia, and pelvis
Endocrine disorders
Excess glucocorticoids Hyperparathyroidism Hypogonadism DM Thyrotoxicosis
Prolonged drug use
Steroids ETOH Dilantin Tobacco Barbiturates Heparin
Other disorders or diseases that contribute
Renal disease
Nutritional deficiencies
SCI - decreased WB, mm cxn
MS
Osteoporosis signs and symptoms
Asymptomatic if uncomplicated
May have pain in mm and bones
Vertebral compressions/crush fractures
Loss of height is common
Multiple compression (mostly anterior) fractures may lead to dorsal kyphosis with an exaggerated cervical lordosis
Vertebral fractures
Often first sign of osteoporosis
Minimal or no trauma WB vertebrae (T8 and below) Pain acute onset Aggravated by WB Usually pain does NOT radiate (centralized)
Dorsal kyphosis and exaggerated cervical lordosis
Dowager’s hump
Central DXA/DEXA
Standardized test for osteoporosis
Dual energy x-ray absorptiometry
Most commonly used and preferred technique
- Measured at hip and spine
- May use radius in forearm if hip or spine cannot be measured
- Test results reported using t-scores
Xray dx
Cannot be diagnosed until >30% bone loss
US dx
Done @ the calcaneus
Not possible to measure hip or spine (too much soft tissue)
