Asymptomatic to severe backache from vertebral fractures. Spontaneous fractures often discovered incidentally on radiography; loss of height. Serum PTH, calcium, phosphorus, and alkaline phos- phatase usually normal. Serum 25-hydroxyvitamin D levels often low as a comorbid condition. Demineralization, especially of spine, hip, pelvis, and wrist
It is defined as low bone mass and micro-architectural destructions of Bone tissue leading fragility and fracture of bone. Bone is normally mineralized but decrease in quantity,quality and Structural Integrity.
Peak bone mass and bone loss are regulated by genetic(80%) and environmental factor (20%),genetic like (ESR1)oestrogen receptor gene,(LRP5)lipoprotein related receptor gene In normal individual 20-40years bone formation is increased but fall after that. After menopause is an accelerated phase of bone loss.
Post menopausal osteoporosis Osteoporosis in men Steroid induced osteoporosis Pregnancy associated osteoporosis Other causes
Asymtomatic until fracture occurs. Osteoporotic spinal fracture present back pain or gradual onset of height loss and kyphosis with chronic pain. in hip fracture affected leg shortened and externally rotated. Some time on bony pain in old age or menupause Incidental osteopenia in xrays performed foe other reasons.
Offer lifestyle advice (e.g. exercise, diet, smoking cessation) Offer treatment: First-line option alendronate or risedronate Also-raloxifene in woman with vertebral osteoporosis -Teriparatide in woman with very severe osteoporosis, or if intolerant to other therapies Give calcium and vitamin D supplements where appropriate