Osteoporosis clinical picture risk factors and treatment

1. Osteoporosis

2. What is osteoporosis ?
• Osteoporosis is systemic skeletal
disease characterized by loss of
bone mass, density, quality, and
strength leading to fragile bones
that break easily.
• The vertebrae, wrist, and hips are
the most common sites of fracture

3. Incidence
• Currently, it has been estimated that more than 200 million
people are suffering from osteoporosis.
• According to recent statistics from the International Osteoporosis
Foundation, worldwide, 1 in 3 women over the age of 50 years and
1 in 5 men will experience osteoporotic fractures in their lifetime.

4. Pathogenesis
• Imbalance between
bone formation
and bone
resorption .
• imbalance in bone
remodeling process
where the
osteoclast cells
exceeds osteoblast
cells

5. Risk factors
•Non modifiable :
Gender
Age
Race
Body frame size
Family history

6. Hormone level :
• Sex hormones: - fall in estrogen level in women at menopause is one of the strongest
risk factors .
-Treatments for prostate cancer that reduce testosterone levels in men.
• Thyroid gland problems: too much thyroid hormone can cause bone loss
• Other glands: like overactive parathyroid and adrenal glands

7. Dietary factors:
Low calcium intake: Low calcium intake contributes to diminished bone
density, early bone loss and an increased risk of fractures.
Eating disorders
Gastrointestinal surgery: Surgery to reduce the size of your stomach or to
remove part of the intestine limits the amount of surface area available to
absorb nutrients, including calcium.

8. • Steroids and other medicines
• Medical problems as :
• Celiac disease.
• Inflammatory bowel disease.
• Kidney or liver disease.
• Cancer.
• Sedentary lifestyle
• Excessive alcohol consumption
• Tobacco use

9. Clinical Picture
Osteoporosis is called a “silent” disease” because there are typically no symptoms until a
bone is broken. But once your bones have been weakened by osteoporosis, you might
have signs and symptoms that include:
Back pain, caused by a broken or collapsed bone in the spine.
Loss of height over time.
A stooped posture.
A bone that breaks much more easily than expected.

10. Investigation
• History of risk factors
• Physical examination
• dual-energy x-ray absorptiometry (DXA): Bone density measurement
by DXA at the hip and spine is generally considered the most reliable way
to diagnose osteoporosis and predict fracture risk. The test provides a t-
score.
• Laboratory test : such as vitamin D deficiency or hyperparathyroidism
• In some cases, additional imaging tests, such as CT scan or MRI may be
used to evaluate the condition of your bones
Diagnosis osteoporosis typically involves a
combination of a physical exam, imaging test,
and laboratory tests.

11. Prevention
• Consumption a diet rich in calcium and
vitamin D
• Engaging in weight-bearing exercises
• Avoid smoking , alcohol consumption
• Marinating a healthy body weight
• Regularly getting screened for bone
density
• Fall prevention

12. Treatment
Medications :
• Bisphosphonates
• Hormone Therapy
• Selective Estrogen Receptor Modulators
(SERMs)
• Calcitonin
• Denosumab
Surgery :
• severe cases or following
fractures, surgical procedures such
as vertebroplasty or kyphoplasty
may be required
•