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3. INTRODUCTION
 Bone is made up of osteoid and mineralization.
 In osteoporosis there is decrease in all constituent
of bone.
 Osteoid is mainly protein.

4. CLINICAL EVALUATION
 Chief complain is pain at vertebrae, neck of femur,
distal radius because these are soft areas. The main
complication is colle’s fracture.
 Pain can be of two types:-
 1. After trauma:- Most common reason is fracture
which can occur due to slight jerk or twisting.
Wedge fracture is most common.
 It is most common in age group more than 50 years.
 Non traumatic :- Height of patient is reduced.
Patient is generally female. Main symptom is cod
fish spine at every IV level.

5. ETIOLOGY
 Primary osteoporosis :- May be age related, Post
menopausal etc.
 Secondary osteoporosis :- Due to Drugs like
steroids, Proton pump inhibitor, Antacid,
Rantidine, can also occur in ulcerative colitis and
metabolic disorder.

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7. INVESTIGATION
 In lab evaluation serum mineralization is normal
 X-RAY :- Compression Fracture, Impacted
fracture. Impacted fracture is when 2 bones are
soft and they merge into each other. It mainly
occur in metaphyseal area because in diaphysis
the bone are hard and they get shattering.
 Another finding in x-ray in cod fish spine

9.  Gold standard for diagnosis is :-
 DEXA (Dual energy x-ray absorptiometry) :- Help in
finding bone mineral density. The number of cells
decrease and minerals and minerals are normal so
bone density decrease.
 DEXA can be small or big machine.
 If we want to access bone mineral density of radius
put hand in machine and scan done of area and
reading is given as printout.
 T-score :- Comparison of bone min. density of patient
with a healthy young individual of same gender and
age.
 In machine there is prefixed value of healthy young
person.

10.  If T score is less than -1 it is normal
 If T score is in between -1 to -2.5 it is osteopenia
 If T score is less than -2.5 it is osteoporosis.
 We recommend DEXA if patient is older than 65
years in every female and above 70 years in every
males.
 Another method is singh index. Dr. singh and his
team tell if all 5 groups of trabeculae are present
than it is normal bone which means as severity of
osteoporosis increase number of trabecular
decrease.

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OSTEOPOROSIS VISIT OUR
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13. TREATMENT
 In this doctor mainly prescribe 2 categories of drug
side by side.
 1. Drugs that inhibit resorption:- They will decrease
further clastic activity. Ex:- Alendronate,
Ibandronate, Risedronate, Zolendronic acid:- This
only gives once in a year and iv 5mg per 100 ml.
 These are first line of drugs.
 When given for longer time they can imcrease
tendency of fracture.
 2. Drugs that promote bone formation
 Both things should go parallel