What is Osteoporosis

Osteoporosis is a progressive bone disease that is characterized by a decrease in bone mass and density which can lead to an increased risk of fracture. In osteoporosis, the bone mineral density (BMD) is reduced. Also the bone microarchitecture deteriorates. The amount and variety of proteins in bone are altered as well.

Causes

The causes of Osteoporosis are, Reduction of estrogen levels post menopause, Deficiency of calcium, vitamin D and phosphorus and medical conditions like over-active thyroid, Diabetes, Rheumatoid arthritis, Anorexia and Bulimia. Certain medicine can also cause Osteoporosis. Only steroids and anticonvulsants are classically associated, but evidence is emerging with regard to other drugs like Barbiturates, phenytoin, L-Thyroxine, aromatase inhibitors used in breast cancer, methotrexate , depot progesterone and gonadotropin-releasing hormone agonists are some of them. Anticoagulants , Proton pump inhibitors , Thiazolidinediones and Chronic lithium therapy has been associated with osteoporosis.

Classification

The disease may be classified as primary type 1, primary type 2, or secondary. The form of osteoporosis most common in women after menopause is referred to as primary type 1 or postmenopausal osteoporosis, which is attributable to the decrease in estrogen production after menopause. Primary type 2 osteoporosis or senile osteoporosis occurs after age 75 and is seen in both females and males at a ratio of 2:1.

Signs and symptoms

Even though Osteoporosis itself has no specific symptoms; Symptoms to look for are pain in the lower or middle back, hunched physique, loss of height and limited mobility. The main consequence is the increased risk of bone fractures. Osteoporotic fractures occur in situations where healthy people would not normally break a bone; they are therefore regarded as fragility fractures. Typical fragility fractures occur in the vertebral column, rib, hip and wrist.

Diagnosis

The diagnosis of osteoporosis can be made using conventional radiography and by measuring the bone mineral density (BMD). The most popular method of measuring BMD is dual-energy x-ray absorptiometry. In addition to the detection of abnormal BMD, the diagnosis of osteoporosis requires investigations into potentially modifiable underlying causes; this may be done with blood tests. Depending on the likelihood of an underlying problem, investigations for cancer with metastasis to the bone, multiple myeloma, Cushing's disease and other above-mentioned causes may be performed.

Management

The risk of osteoporosis fractures can be reduced with lifestyle changes and in those with previous osteoporosis related fractures, medications. Lifestyle change includes diet, exercise, and preventing falls. A scientific review found insufficient evidence to recommend calcium and vitamin D supplements to prevent fractures. Bisphosphonates are useful in those with previous fractures from osteoporosis but are of minimal benefit in those who have osteoporosis but no previous fractures.