osteoporosis dr. faik altıntaş yeditepe Üniversitesi tıp fakültesi ortopedi ve travmatoloji ad
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Osteoporosis
Dr. Faik AltıntaşYeditepe Üniversitesi Tıp Fakültesi
Ortopedi ve Travmatoloji AD
OsteoporosisS.E. 84 y o femaleRight hip pain after minor trauma in
householdCould not walk after the fall and had agony6 hours after fall, administrated to the
hospital
Osteoporosis
Osteoporosis
OsteoporosisOsteoporosis is a disease of
bone that leads to an increased risk of fracture
In osteoporosis The bone mineral density
(BMD) is reducedBone microarchitecture is
disruptedThe amount and variety of
non-collagenous proteins in bone is altered
OsteoporosisPrimary Osteoporosis
More than 95% of osteoporosis in women Most cases occur in postmenopausal womenPostmenopausal, involutional, senile, and age-
related osteoporosis are synonimsCause of osteoporosis is a lack of estrogenEstrogen deficiency increases bone breakdown and
results in rapid bone lossBone loss is even greater if calcium intake or vitamin
D levels are low. Low vitamin D levels result in calcium deficiency and increased activity of the parathyroid glands (secreting parathyroid hormone), which can also stimulate bone breakdown
Bone production also decreases
OsteoporosisSecondary Osteoporosis
Chronic kidney failureHormonal disorders (especially
Cushing's disease, hyperparathyroidism, hyperthyroidism, hypogonadism, and diabetes mellitus)
Drugs (corticosteroids, barbiturates, and anticonvulsants)
OsteoporosisBreaks usually occur in the hip, spine and wristHip and spine fractures are a major
concernHip fractures almost always require
surgery and hospitalizationSpine fractures have serious
consequences such as loss of height, severe back pain, and deformity
Osteoporosis
When you are young your body makes new bone faster than it breaks down old bones
As you get older, this process slows down and you start losing bone density
The risk for osteoporosis depends on how much bone mass you attained to age 30 and how fast you lose it
As part of the aging process, bones begin to break down faster than they are formed.
Accelerates after menopause. Estrogen is the hormone that protects against bone loss
Osteoporosis
Certain people are more likely to develop this disease than others
FemaleThin and/or small frameAdvanced ageFamily history of osteoporosisPost menopause
OsteoporosisAnorexia nervosa or bulimiaDiet low in calciumUse of certain medicationsLow testosterone levels in menAn inactive lifestyleCigarette smokingExcessive use of alcohol, coffeeBeing Asian or Caucasian
Osteoporosis Symptoms
At first, osteoporosis causes no symptoms because bone density loss occurs very gradually
Some people never develop symptoms.Eventually bone density may decrease enough for
bones to collapse or fractureSevere sudden pain or gradually developing aching
bone pain and deformitiesVertebral crush fractures ,the weakened vertebrae
may collapse spontaneously or after a slight injuryChronic back pain , an abnormal curvature of the
spine (a “dowager‘s hump”)
OsteoporosisDiagnosis
Suspect osteoporosis in the following peopleAll women age 65 or olderWomen aged 50 to 65 who have risk factors for osteoporosisAll men and women who have had a previous osteoporotic fracture (a
fracture caused by little or no force), even if the fracture occurred at a young age
Adults age 65 or older who have unexplained back painPeople whose bones appear thin on x-rays
Bone density testing , the dual-energy x-ray absorptiometry (DEXA), which measures bone density at the sites at which major fractures are likely to occur: the spine and hip.
Blood tests may be performed to measure calcium and vitamin D levels Further testing may be needed to rule out treatable conditions for secondary
osteoporosis
OsteoporosisDual energy X-ray absorptiometry (DXA,
formerly DEXA)Gold standard for the diagnosis of osteoporosis Osteoporosis is diagnosed when the bone mineral
density is less than or equal to 2.5 standard deviations below that of a young adult reference population. This is translated as a T-score
T-score -1.0 or greater is "normal" T-score between -1.0 and -2.5 is "osteopenia"T-score -2.5 or below is “osteoporosis “
OsteoporosisPreventation
Building strong bones in childhood and adolescence is the best defense
A balanced diet rich in calcium and Vitamin D
Weight bearing exerciseA healthy lifestyle with no smoking or
excessive alcohol or coffee intakeBone density testing and medication
when appropriate.
OsteoporosisTreatment Adequate intake of calcium (after fifty years of age 1,200 mg/day)Vitamin D (after fifty years of age 800IU/day)Weight-bearing exercisesDrugs
Bisphosphonates Alendronate Risedronate IbandronateZoledronic acid
CalcitoninSelective estrogen receptor modulator (SERM)
RaloxifeneParathyroid hormone
Teriparatide