Reduced Bone mass

Primary - age related Secondary - to another condition or drug

If trabecular Bone is affected, crush fractures of vertebrae are common. If cortical Bone is affected, long Bone fractures are more likely Hip Fractures

Causes/Factors

SHATTERED for Osteoporosis risk factors

Steroid use of >5mg/day of Prednisolone Hyperthyroidism, hyperparathyroidism, hypercalciuria Alcohol and tobacco use Thin - BMI < 18.5 Testosterone Early menopause Renal or Liver failure Erosive/inflammatory Bone disease - Multiple myeloma or Inflammatory Arthritis Dietary low calcium absorption - T1 Diabetes Mellitus

Symptoms

  • Associated fractures
  • Loss of height

Diagnostic Tests

  • Diagnosing Osteoporosis involves a Bone density test, typically measured by dual-energy X-ray absorptiometry (DXA or DEXA). This test measures Bone mineral density (BMD) and assesses the risk of fractures.
  • Bloods - Ca, PO4, ALP (for Bone mets)

Biopsy unreliable and unnecessary

Management

May not be entirely irreversible

  1. Calcium and Vitamin D Supplements: Adequate calcium and vitamin D intake are essential for Bone health.
  2. Lifestyle Changes: Regular weight-bearing exercises, quitting smoking, and moderating alcohol intake.
  3. Medications: Various medications, including bisphosphonates, hormone therapy, and denosumab, may be prescribed to strengthen bones.
  4. Fall Prevention: Taking steps to prevent falls, such as using assistive devices and making home modifications.
  5. Fracture Management: Treatment of fractures if they occur, including pain management and rehabilitation.

Complications/red Flags

  • Fractures: The main complication of Osteoporosis, fractures can lead to pain, disability, and a decreased quality of life.
  • Loss of Independence: Severe fractures, especially Hip Fractures, can lead to a loss of independence.