1. Osteoporosis Dr. Faik Altıntaş Yeditepe Üniversitesi Tıp Fakültesi
Ortopedi ve Travmatoloji AD

2. Osteoporosis S.E. 84 y o female
Right hip pain after minor trauma in household
Could not walk after the fall and had agony
6 hours after fall, administrated to the hospital

3. Osteoporosis

4. Osteoporosis

5. Osteoporosis
Osteoporosis is a disease of bone that leads to an increased risk of fracture
In osteoporosis
The bone mineral density (BMD) is reduced
Bone microarchitecture is disrupted
The amount and variety of non-collagenous proteins in bone is altered

6. Osteoporosis Primary Osteoporosis
More than 95% of osteoporosis in women
Most cases occur in postmenopausal women
Postmenopausal, involutional, senile, and age-related osteoporosis are synonims
Cause of osteoporosis is a lack of estrogen
Estrogen deficiency increases bone breakdown and results in rapid bone loss
Bone 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

7. Osteoporosis Secondary Osteoporosis Chronic kidney failure
Hormonal disorders (especially Cushing's disease, hyperparathyroidism, hyperthyroidism, hypogonadism, and diabetes mellitus)
Drugs (corticosteroids, barbiturates, and anticonvulsants)

8. Osteoporosis Breaks usually occur in the hip, spine and wrist
Hip and spine fractures are a major concern
Hip fractures almost always require surgery and hospitalization
Spine fractures have serious consequences such as loss of height, severe back pain, and deformity

9. 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

10. Osteoporosis
Certain people are more likely to develop this disease than others
Female
Thin and/or small frame
Advanced age
Family history of osteoporosis
Post menopause

11. Osteoporosis Anorexia nervosa or bulimia Diet low in calcium
Use of certain medications
Low testosterone levels in men
An inactive lifestyle
Cigarette smoking
Excessive use of alcohol, coffee
Being Asian or Caucasian

12. 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 fracture
Severe sudden pain or gradually developing aching bone pain and deformities
Vertebral crush fractures ,the weakened vertebrae may collapse spontaneously or after a slight injury
Chronic back pain , an abnormal curvature of the spine (a “dowager‘s hump”)

13. Osteoporosis Diagnosis Suspect osteoporosis in the following people
All women age 65 or older
Women aged 50 to 65 who have risk factors for osteoporosis
All 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 pain
People 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

14. Osteoporosis Dual 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 “

15. Osteoporosis Preventation
Building strong bones in childhood and adolescence is the best defense
A balanced diet rich in calcium and Vitamin D
Weight bearing exercise
A healthy lifestyle with no smoking or excessive alcohol or coffee intake
Bone density testing and medication when appropriate.

16. Osteoporosis Treatment Adequate intake of calcium (after fifty years
of age 1,200 mg/day)
Vitamin D (after fifty years of age 800IU/day)
Weight-bearing exercises
Drugs
Bisphosphonates
Alendronate
Risedronate
Ibandronate
Zoledronic acid
Calcitonin
Selective estrogen receptor modulator (SERM)
Raloxifene
Parathyroid hormone
Teriparatide

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