OSTEOPOROSIS

CLINICAL MANIFESTATIONS

• FRAGILITY FRACTURES.• COMPRESSION

FRACTURE.• RADICULOPATHIC PAIN.• SPINAL CORD

COMPRESSION OR CAUDA EQUINA SYNDROME.

STOOPED POSTUREKYPHOSIS

• INCREASED RISK FOR FALLING ASSOCIATED WITH AGING.

• IMPAIRED BREATHING.

DIAGNOSIS

MANAGEMENT

1. LIFE STYLE CHANGES• Dietary intake of adequate calcium and vit. D.• Weight bearing.• Harmone replacement therapy.• Cigarette and alcohol cessation.• Protein supplementation.• Exposure to sunlight.

2. EXERCISE

3. MEDICATIONS

• ANTIRESORPTIVE AGENTSBisphosphonatesEstrogen analogsRaloxifeneCalcitonin

• BONE ANABOLIC AGENTSFluoridesTeripartideVitamin D supplementCalcium Salts

OSTEOMALACIA

PATHOPHYSIOLOGYINADEQUATE Ca++ & VIT D IN DIET

INCREASED URINARY

EXCRETION OF Ca++

LOSS OF Ca++ & PHOSPHOROUS

DURING PREGNANCY AND LACTATION

INADEQUATE CONCENTRATION OF CALCIUM OR PHOSPHORUS IN THE BODY

DECALCIFICATION OF THE BONES

SOFTENING OF THE BONES

DIAGNOSTIC EVALUATION

• DECREASED SERUM CALCIUM LEVEL.• DECREASED SERUM POTASSIUM LEVEL.• INCREASED SERUM ALKALINE PHOSPHATASE

LEVEL.• DECREASED URINARY CALCIUM.• X-RAY: PSEUDO-FRACTURES (MILKMAN’S

SYNDROME).• BONE BIOPSY: DEMONSTRATE AN EXCESS OF

OSTEOID.

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