This document discusses osteoporosis and osteomalacia. It outlines the clinical manifestations of osteoporosis which include fragility fractures, compression fractures, and spinal issues. It also mentions stooped posture and increased falling risk. Management involves lifestyle changes like diet, exercise, supplements and medications. Medications include bisphosphonates, estrogen analogs, calcitonin and others. It then discusses osteomalacia and notes its pathophysiology is inadequate calcium and vitamin D intake leading to decalcification of bones and softening of bones. Diagnosis involves lab tests and x-rays showing pseudofractures.

1. OSTEOPOROSIS

2. CLINICAL MANIFESTATIONS
• FRAGILITY FRACTURES.
• COMPRESSION
FRACTURE.
• RADICULOPATHIC PAIN.
• SPINAL CORD
COMPRESSION OR
CAUDA EQUINA
SYNDROME.

4. STOOPED POSTURE
KYPHOSIS

5. • INCREASED RISK FOR FALLING ASSOCIATED
WITH AGING.
• IMPAIRED BREATHING.

6. DIAGNOSIS

7. MANAGEMENT
1.
•
•
•
•
•
•
LIFE STYLE CHANGES
Dietary intake of adequate calcium and vit. D.
Weight bearing.
Harmone replacement therapy.
Cigarette and alcohol cessation.
Protein supplementation.
Exposure to sunlight.

8. 2. EXERCISE

9. 3. MEDICATIONS
• ANTIRESORPTIVE AGENTS
Bisphosphonates
Estrogen analogs
Raloxifene
Calcitonin
• BONE ANABOLIC AGENTS
Fluorides
Teripartide
Vitamin D supplement
Calcium Salts

10. OSTEOMALACIA

11. PATHOPHYSIOLOGY
INADEQUATE Ca++
& VIT D IN DIET
INCREASED
URINARY
EXCRETION OF
Ca++
LOSS OF Ca++ &
PHOSPHOROUS
DURING PREGNANCY
AND LACTATION
INADEQUATE CONCENTRATION OF CALCIUM OR PHOSPHORUS IN THE BODY
DECALCIFICATION OF THE BONES
SOFTENING OF THE BONES

12. DIAGNOSTIC EVALUATION
• DECREASED SERUM CALCIUM LEVEL.
• DECREASED SERUM POTASSIUM LEVEL.
• INCREASED SERUM ALKALINE PHOSPHATASE
LEVEL.
• DECREASED URINARY CALCIUM.
• X-RAY: PSEUDO-FRACTURES (MILKMAN’S
SYNDROME).
• BONE BIOPSY: DEMONSTRATE AN EXCESS OF
OSTEOID.