Osteoporosis Flashcards
Define OP
Generalized metabolic skeletal disorder characterized by compromised bone strength, low bone mineral density, and deterioration of bone quality often leading to a fragility fracture
What are risk factors for OP?
• Female • Previous fragility fracture • Frequent use of glucocorticoids • Premature menopause (<45years old) • History of falls • Family history of hip fracture • Low BMI • Smoking • Alcohol intake >14 units per week • Aromatase inhibitors (female) Androgen deprivation treatment (male)
What conditions are associated with OP?
• Diabetes • Osteogenesis imperfecta • Hyperthyroidism/Hyperparathyroidism • Hypogonadism / premature menopause • Chronic Malnutrition • Malabsorption e.g. Crohn’s disease Chronic Liver Disease
What are clinical features of OP?
Often asymp.
* Back pain: due to vertebral fracture * Kyphosis * Impaired gait and imbalance
Who should be assessed/screened for OP
• All women >65 years
• All men >75 years
Women and men >50 years with risk factors e.g. previous fragility fracture, glucocorticoid use
What scores are used to predict risk of OP?
FRAX and Qfracture
What Ix in OP?
DEXA scan: T score <2.5 = OP
X-rays can show fractures, but can’t diagnose
Bloods: bone profile, vit D, PTH
?multiple myeloma screen
What are differentials for OP?
• Multiple myeloma • Osteomalacia • CKD bone mineral disorder • Primary hyperparathyroidism • Metastatic bone malignancy Vertebral deformities
What is Rx of OP?
Weight-bearing exercises
Smoking cessation
Oral Ca/vit D supplementation
Bisphosphonates (alendronic 1/52, zolendronic 1/365)
What are SE of bisphosphonates?
- Heartburn/indigestion
- Pain or stiffness in muscles, joints or back
- Headache
- Tiredness
Less common side effects:
• Ulcers of stomach/oesophagus
• Atypical femoral fracture
• Osteonecrosis of jaw
What are complications of OP?
• Fractures
○ Fragility
○ Femoral associated with bisphosphonates
• Chronic pain
