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Flashcards in Osteoporosis Deck (14)
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1

3 types of osteoporosis

  1. primary
  2. secondary
  3. transient osteporosis of the hip

2

What is primary osteoporosis? 

deterioration of bone mass, unassociated with other chronic illnesses or diseases

-Usually related to aging, menopause

3

What is secondary osteoporosis? 

caused by various endocrine or metabolic disorders (G&S, Table 11-13, p. 439)

4

What is transient osteoporosis of the hip? 

rare, idiopathic, transitory 

- middle-aged men and pregnant women

5

Pharmacology for Treatment of

Osteopenia/Osteoporosis (4)

  • Calcium supplements, ~ 1000 units/day
  • Vitamin D ~ 2000 units/day
  • Biophosphonates-(work by osteoblast activity, interferes/changes bonebuilding)- osteoporosis, Paget’s disease, others
    • Fosamax, Aredia, etc.
  • Estrogen therapy for post menopausal women and ovariectomy (also called oophorectomy) to preserve bone density

6

Methods for screening for osteoporosis

  • FRAX (Fracture Risk Assessment, WHO)

  • DEXA scan (Dual Energy X-ray Absorptiometry)

7

At what age do we start screening women for osteporosis? 

60 

•50% of women will fall below normal bone mineral density T-score and be candidates for medical treatment

8

Points about osteoporosis, age, and changes in bone

  • Age related bone remodeling and body type
    • Breakdown is greater than build-up
    • Bone growth and storage into the 20’s -  diet and exercise puts bone in the bank!
  • Systemic and bilateral
    • Fracture and deformity risk systemically

9

Vertebral fractures and osteoporosis (pic)

10

What is Osteomalacia?

  • Softening of bones due to vitamin D deficiency, lack of exposure to UV rays
  • (note:  ability to synthesis vitamin D through sunlight diminishes after age 40)
  • Looser’s transformation zones – pseudofractures in areas of demineralization
  • Called “rickets” in children, usually malnutrition – causes bowing of long bones due to malformation with epiphyseal plates
  • May have bowed legs 

11

What is Paget's disease? (3)

  • Genetic factors or viral infection that produces disordered bone modeling (not systemic)
  • Produces larger bone when it heals, but is weaker
    • Fracture risk, deformity
  • Specific area, not systemic
    • Pelvis, spine, skull, tibia (unilateral), etc.

12

List of things to think about for treatment of people with osteoporosis or Paget's disease (7)

  1. Exercise–Stretching, strengthening, balance, weight bearing activity (30 min a day) 
  2. Assistive device/bracing
  3. Sunlight- for vitamin D (ability to absorb decreases with age)
  4. Surgery- depending on degree of deformity
  5. Diet/Supplements
  6. Smoking- quit
  7. Alcohol consumption- moderation

13

Norms for T-scores (from Dexa scan) 

  • -1 and above
    • Your bone density is considered normal
  • -1 and -2.5
    • Your score is a sign of osteopenia, a condition in which bone density is below normal and may lead to osteoporosis.
  • -2.5 and below
    • Your bone density indicates you likely have osteoporosis.

14

Points about treatment of vertebral fractures

  • It's a mega bummer
  • Typically T-spine
  • Putting people into a brace which puts them into extension while Fx heals