According to National Osteoporosis Foundation in 2015, Osteoporosis was estimated to affect 75million people in Europe, USA and Japan and 200 million women worldwide. In this article, the role of calcium and vitamin D in bone building has been explained and has provided the relevant approaches in diagnosis of suspected cases of Osteoporosis.

1. OSTEOPOROSIS,
DIAGNOSIS
&
MANAGEMENT.
BY
SCT.NWUDELE CHIBUEZE

2. OUTLINE.
•INTRODUCTION
•FUNCTONS OF BONE
•CAUSES AND CONSEQUENCES
•ROLES OF VITAMIN D, CALCIUM AND EXERCISE
•RISK FACTORS OF OSTEOPOROSIS
•OSTEOPOROSIS DIAGNOSIS
•MANAGEMENT OF OSTEOPOROSIS
•CONCLUSION
•RECOMMENDATION
•REFERENCES

3. Vertebral Fracture Cascade

4. LEARNING OBJECTIVES
• To understand how osteoporosis is caused.
• To understand why calcium, vitamin D and Exercise
are important in preventing osteoporosis.
• To understand the risk factors that associate
osteoporosis and how to handle some of the risk
factors.
• To outline the consequences of osteoporosis.
• To learn different approaches used in diagnosing
osteoporosis.
• To understand the basis of osteoporosis drug
treatment.

5. INTRODUCTION
• Osteoporosis is a condition in which bones lose their strength and are more
likely to break, usually following a minor bump or fall (NOS, 2015). Broken
bones are also referred to as ‘fractures’.
• Fractures that occur because of reduced bone strength are described as
‘fragility fractures’ and many of these will be caused by osteoporosis.
• One in two women and one in five men over the age of 50 experience
fractures, mostly as a result of low bone strength (NOS, 2015)
• Although fragility fractures caused by osteoporosis can happen in various
parts of the body, the wrists, hips and spine are the most commonly affected
sites.
• Osteoporosis is also a term used to describe low bone density as measured
on a bone density (DXA) scan. This means your bones may have lost
strength.

6. FUNCTIONS OF BONE
• Support
• Protection for internal organs
• Storage of calcium and other minerals.
• Protect bone marrow centre, for blood cell
formation.
• Allow movement.

7. BONE AND OSTEOPOROSIS
• Bone contains fibres and minerals (calcium
mainly).
• Bone production occurs more often than
resorption from birth to age 35.
• This means the bones loss strength and
density.
• If small amount is lost continually, it results
in osteoporosis but if bone loss large
osteoporosis results.

8. WHO CAN SUFFER OSTEOPOROSIS
• Women,
• Men,
• Younger men and women.

9. HOW OSTEOPOROSIS AFFECT YOU
(consequences of osteoporosis)
• Broken wrists.
• Broken hips
• Spinal fractures
• Loss of height and spinal curvature (Dowager’s
hump).

10. SYMPTOMS
 Back pain, which can be severe if fractured or collapsed
vertebra
 Loss of height over time, with an accompanying stooped
posture
 Fracture of the vertebrae, wrists, hips or other bones

11. Wrist fracture.

12. Hip fracture in osteoporosis

13. Height loss in osteoporosis

14. TYPES OF COMPRESSION FRACTURE

15. HEALTH BENEFITS OF CALCIUM,
VITAMIN D AND EXERCISE
CALCIUM
• Gives strength and rigidity to bones.
• 99% of the body content (1kg) and in the bones.
• Healthy balance diet with adequate calcium and
protein as well as vitamin D are essential for baby to
develop a healthy skeleton (NOS, 2014).
• Higher intakes of calcium and protein are required
during adolescence

18. Vitamin D
• Vitamin D helps in the absorption of calcium.
• The major source of vitamin D is sunlight
• Ultraviolet part of sunlight convert the inactive
form of vitamin D to active form.
• Building healthy bones actually starts in the
womb.

19. SOURCES OF CALCIUM
• Cheese and egg (quiche).
• Yoghurt .
• Porridge (made with semi-skinned milk).
• Sardines.
• Green beans.
• Tinned tomatoes.
• Fried onions.
• Water cress etc.

20. (NOS, 2014)

21. EXERCISE
• Exercise is important for everyone at all stages of lives, but is
especially important for people with osteoporosis and risk of
fracture.
• Helps to build strong bones in childhood.
• Prevents bone loss and maintains muscle strength in adults.
• Increase balance and posture, prevent weak bones and
fracture in elderly.
• Aids rehabilitation (rebuilding of the bone, relief from pain).

22. Adults Are Also Involved In Exercise

23. Exercise

25. What keeps bones healthy
• Regular exercise
• Adequate amounts of calcium
• Adequate amounts of vitamin D, which is very essential
for absorbing calcium

26. RISK FACTORS OF OSTEOPOROSIS
• Fixed risk factors,
• Modifiable risk factors

27. Fixed risk factors of osteoporosis
• Age
• Gender
• Ethnicity
• Fractures (previous fracture)
• Genes
• Menopause
• Hysterectomy

28. Modifiable Risk Factors Of Osteoporosis
• Alcohol
• Tobacco/smoking.
• Low BMI
• Poor nutrition
• Eating disorder
• Frequent falls and injuries
• Steroid use.

29. Cigarette As A Risk Of Osteoporosis

30. DIAGNOSIS OF OSTEOPOROSIS
• Dual energy X-ray absorptiometry (DXA).
• Urine and blood tests (bone markers).
Markers of bone resorption include:
• Telopeptide
• N-telopeptide (NTX) – ELISA method.
• C-telopeptide (CTX) – ELISA method.
Markers of bone formation
• bone Alp
• Osteocalcin

31. • Measurements of Calcium and Vitamin D
• Computerized tomography (CT) scanning.
• Magnetic resonance imaging (MRI).
• X-rays.
• Bone (Radioisotope) scanning.

32. Dual energy X-ray absorptiometry (DXA) (NOS, 2014)

33. Computerized tomography scanning

34. MANAGEMENT
• What do drug treatments for osteoporosis do and
how do they work?
• Drug treatments for osteoporosis help to
strengthen your bones and reduce your risk of
having fractures.
• Most drug treatments work by slowing down the
activity of the cells that break down old bone
(osteoclast) and they are called antiresorptive
drugs.

35. MANAGEMENT CONTD
• Others work to stimulate the cells that build new
bone (osteoblast) and they are called anabolic
drugs.
• The main aim of these drugs is to decrease the
risk of breaking bones .
• Often treatment will show an increase in bone
density as well.

36. WHICH DRUGS ARE AVAILABLE?
• Bisphosphonate 70mg/week (tablet).
• Alendronate 70mg/week (tablet).
• Risedronate
• Selective oestrogen receptor
• Parathyroid hormone treatment.

37. • CONCLUSION
• Osteoporosis is a common form of bone disease,
and it is characterized by low bone mass and
deterioration of the bone structure. While many
osteoporosis prevention studies have focused on
calcium, the emphasis for some of these studies has
now shifted toward the importance of vitamin D
and regular exercise in the management of this
disease. In order to maintain healthy bone strength
and integrity, 700mg of calcium is recommended
daily for adults, regular exercise and those modifiable
risk factors discussed in this work are encouraged to
be modified.

38. REFERENCES
• David B. E, Robert K. R (2012).Disorders of Bone. In: C.
A Burtis, E. R Ashwood, D. E Brun. Tietz
Foundermentals of Clinical Chemistry, 6th edn. Saunders,
Elsevier pp 711-734.
• National Osteoporosis Society, 2015. An Introduction to
Osteoporosis; A short Guide to Bone Health, Fragile
Bones and Fractures. www.nos.org.uk pp 1-26.
• National Osteoporosis Society, 2014. Scans and Tests and
Osteoporosis. www.nos.org.uk. pp 1-28

39. THANK YOU
IMMENSELY
FOR
YOUR TIME