The process of bone loss speeds up for several years after the menopause, when the ovaries stop producing the female sex hormone oestrogen. Successful early diagnosis can lead to effective treatment strategies that reduce. This is a result of a lack of 1 or more of the factors necessary for osteogenesis. Osteoporosis epidemiology etiology diagnosis fracture osteoporosis, a major public health problem, is becoming increasingly prevalent with the aging of the world population. Jul 22, 2019 osteoporosis occurs when bone density decreases. Osteoporosis one of the major cause for the fracture among aged and. The exact mechanisms of this steroid hormone deficiency in postmenopausal women as well as in the elderly men are continuously being unraveled. This is to say that it refers to a decrease in the hard portions of bone substance in favor of a relative increase in the soft portions. Osteoporosis is a classical agerelated disease that affects women more often than men.
With either or both of these conditions, many people benefit from exercise programs that may include physical therapy and rehabilitation. Osteoporosis is a complex skeletal disease characterized by low bone density and microarchitectural defects in bone tissue, resulting in increased bone fragility and susceptibility to fracture. However, as osteoporosis is widely underdiagnosed, the first clinical symptom is often a lowenergy fracture of the spine or hip. Osteoporosis is a major cause of morbidity among the elderly. Broken bones from osteoporosis cause serious health. Osteoporosis is a multifactorial disorder associated with low bone mass and enhanced skeletal fragility. Epidemiology, etiology, and diagnosis of osteoporosis american. There have been several pieces of evidence suggesting that excessive or unbalanced action of parathyroid hormone may be responsible. Attention is frequently called to the condition by the pain and deformity incident to collapse of the vertebral bodies, or to pathological fractures in the spine. Osteoporosis is a systemic skeletal disease characterized by a low bone mass and abnormal bone architecture, which leads to compromised bone strength and a consequent increase in bone fragility. Recent research has focused on the determinants of postmenopausal osteopenia and of postmenopausal osteoporosis.
The measure of osteoporosis also depends on peak adult bone mass that is usually reached around age 30 possibly earlier for trabecular bone. Osteoporosis may develop if this breakdown occurs excessively. Trabecular bone is the spongy bone tissue found at the end of. The following table is a list of evidencebased recommendations for the diagnosis and treatment of osteoporosis. Osteoporosis is a skeletal disorder characterized by compromised bone strength, which predisposes the individual to an increased risk of fractures of the hip, spine. Osteoporosis, a major public health problem, is becoming increasingly prevalent with the aging of. Trabecular bone is the spongy bone tissue found at the end of vertebrae and long bones, while cortical bone is the outer shell and middle of long bones. Men and women of any age with conditions known to be secondary causes of osteoporosis no every 210 years. Osteoporosis is defined elsewhere in this issue as a condition of skeletal fragility characterized by reduced bone mass and microarchitectural deterioration of bone tissue with a consequent increase in risk of fracture. Osteoporosis symptoms, diagnosis and treatment bmj. Osteoporosis is a skeletal disorder characterized by compromised bone strength, which predisposes the individual to an increased risk of fractures of the hip, spine, and other skeletal sites. The con dition when bone mass drops to a critical level below which fracture risk is substantially higher is termed osteo porosis 17. Obesity has also been associated with a greater risk of fracture in men. Risk factors in men and women include smoking, family history of fracture, age greater than 65 years and low bmi.
Osteomalacia results from defective bone mineralization. Apr 17, 2020 osteoporosis meaning porous bone is a bone disease in which bone loss occurs, so that bones become weak and are more likely to break. Decreased bone strength is related to many factors other than bone mineral density bmd, including rates of bone formation and resorption turnover, bone geometry size. Osteoporosis is a highly prevalent, treatable disease, but it is currently incurable. Osteoporosis is most common in women after menopause, but anyone.
Osteoporosis osteoporosis is a disease of the bones that causes. It can affect both males and females, but it is most likely to occur in women after menopause because of the sudden decrease in. Osteoporosis is characterized by low bone mineral density. Active vitamin d, also called calcitriol, is more like a hormone than a vitamin.
In the united states, europe and japan, osteoporosis affects about 75 million people 2. Although human osteopetrosis is a heterogeneous disorder encompassing different molecular lesions and a range of clinical features, all forms share a single pathogenic nexus in the osteoclast. The pathogenesis, diagnosis, investigation and management. Too little vitamin d can lead to weak bones and increased bone loss. Diagnosis and treatment osteoporosis is diagnosed either through. Although human osteopetrosis is a heterogeneous disorder encompassing different molecular lesions and a range of clinical features, all forms share a. Pdf etiology and pathogenesis of osteoporosis researchgate. Case of 65 year old lady bone mineral density dxa shows tscore of 2. Osteopetrosis was first described in 1904, by german radiologist albersschonberg. Osteoporosis is a systemic skeletal disorder which. Using the who criteria, 30% of postmenopausal caucasian women have osteoporosis at the hip, lumbar spine or distal forearm 3.
With an increasingly ageing population, osteoporosis and osteoporosis related fractures is fast becoming an important public health problem placing a considerable economic burden on health service resources. Fracture risk assessment and the evaluation and treatment of osteoporosis in men are discussed separately. Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue with a. Professional version the trusted provider of medical. Successful early diagnosis can lead to effective treatment strategies that reduce the risk of a patients life being compromised by serious fracture injury. Vitamin d deficiency is the primary cause of osteomalacia in the western world, resulting from inadequate endogenous production of vitamin d3 in the skin related to suboptimal uvb sunlight exposure and the use of sunscreen, insufficient dietary supplementation, andor the inability of the small intestine to absorb adequate amounts of dietary sources of vitamin d. Diagnosis and treatment of osteoporosis ninth editionjuly 2017 topic recommendation relevant resources assessment icsi work group consensus recommendation 1. Osteoporosis is characterized by low bone mass, microarchitectural disruption, and skeletal fragility, resulting in decreased bone strength and an increased risk of fracture. The progress of diagnostic imaging and quantitative measurement of osteoporosis is significantly helping epidemiological studies to find the etiology of osteoporosis. Osteoporosis is most common in women after menopause. See osteoporotic fracture risk assessment and clinical manifestations, diagnosis, and evaluation of osteoporosis in men and treatment of osteoporosis in men. The thinner this layer is, the more susceptible it will be to. Osteoporosis causes, symptoms, treatment versus arthritis. Osteoporosis is a systemic skeletal disease characterized by a low bone mass and abnormal bone architecture, which leads to compromised bone strength and a consequent increase in bone fragility and risk of fracture.
Osteoporosis and arthritis do share many coping strategies. The hypothesis that osteoporosis is a consequence of estrogen deficiency, has been proposed as. Recent research has focused on the determinants of. Elderly people are the fastest growing population in the world and, as people age, bone mass declines and the risk of fractures increases. Pathophysiology of osteoporosis endocrinology and metabolism. Osteoporosis is a disease characterized by low bone mass and loss of bone tissue that may lead to weak and fragile bones if you have osteoporosis, you have an increased risk for fractured. Osteoporosis literally leads to abnormally porous bone that is. The hypothesis that osteoporosis is a consequence of estrogen deficiency, has been proposed as early as 1941. This disorder of the skeleton weakens the bone and results in frequent fractures breaks in the bones.
Anyone can get osteoporosis but women are about four times more likely than men to develop it. By dr john h maher it has been recognized for decades that vegetarians have a lower incidence of osteoporosis. Osteoporosis is common in the uk, and the risk increases with age. Osteoporosis, a major public health problem, is becoming increasingly prevalent with the aging of the world population. Too much bone is broken down, and too little new bone is built back up. Osteoporosis or its early warning sign, osteopenia, signals an imbalance in the remodeling process. The pathogenesis, diagnosis, investigation and management of. Osteoporosis is defined elsewhere in this issue as a condition of skeletal fragility characterized by reduced bone mass and microarchitectural deterioration of bone tissue with a consequent increase in. Osteoporosisrelated fractures most commonly occur in the hip, wrist or spine. Osteoporosis causes bones to become weak and brittle so brittle that a fall or even mild stresses such as bending over or coughing can cause a fracture. Health care guideline diagnosis and treatment of osteoporosis. Without prevention or treatment, osteoporosis can progress without pain or symptoms until a bone breaks fractures. Secondary osteoporosis refers to osteoporosis in which an underlying cause or factor other than those attributable to the postmenopausal state or aging can be.
Until recently, however, the field was a veritable tower of babel. During the past 2 decades, important insights to understanding osteoporosis have come from several disciplines. For example, young adults with wider femurs might be at higher risk for hip fractures late in life because, on average, wider bones tend to have thinner cortical layers. Osteoporosis symptoms, diagnosis and treatment bmj best. The diagnosis of osteoporosis is usually based on radiographic evidence of collapsed vertebrae, expanded intervertebral disks, and thinning of the cortex of the bones. Biochemical investigations have revealed that a deficiency in calcium absorption and imbalanced calcium regulating hormones are a cause of osteoporosis. Bone is living tissue that is constantly being broken down and replaced. This affects the structure and strength of bones and makes fractures more likely. Osteoporosis keywords osteoporosis, osteoporosis in women,bisphosphonates, osteoporosis medicines. Fractures from osteoporosis commonly occur in the hip, spine, ribs, and wrist. Osteoblasts cells that make the organic matrix of bone and then mineralize bone and osteoclasts cells that resorb bone are regulated by parathyroid hormone pth, calcitonin, estrogen, vitamin d, various cytokines, and other local factors such as prostaglandins. Osteoporosis musculoskeletal and connective tissue.
Osteoporosis, a chronic, progressive disease of multifactorial etiology see etiology, is the most common metabolic bone disease in the united states. However, there are certain common causes of bone loss and increased fracture risk with aging in most people. The epidemiology and pathogenesis of osteoporosis endotext. This does not account for the substantial pain, disability and indeed mortality incurred after a fracture, particularly a hip fracture.
Osteoporosis, the most common disorder of the skeletal system, occurring chiefly in elderly persons, means literally an increased porosity of bone. Low bone mass is thus visualized as a risk factor for fracture. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. No matter your age, you can take steps to build bone mass and prevent bone loss. In the united states, europe and japan, osteoporosis affects. The pathophysiology of osteoporosis is an imbalance between bone resorption and bone formation. It has been most frequently recognized in elderly white women, although it does occur in both sexes, all races, and all age groups. Diagnosis and treatment of osteoporosis ninth editionjuly 2017 topic. Men and women of any age with conditions known to be secondary causes of osteoporosis no every 210 years depending on initial tscore see p. Osteoporosis screening, diagnosis, and treatment guideline. Osteoporosis a current view of pharmacological prevention and treatment. Normally, bone formation and resorption are closely balanced. Osteoporosis, defined by the world health organization who as a bone mineral density bmd tscore less than 2. Osteoporosis is a systemic skeletal disorder which results from an imbalance in bone remodelling, leading to a reduction in bone strength, with microarchitectural.
953 717 1474 43 676 811 175 1333 895 1553 417 318 916 798 1123 192 313 217 7 935 130 1445 517 1110 34 654 136 846 737 1094 340 930 536 708 163 1053 1449 983 467 283 466 724