Osteoporosis is a skeletal disorder characterized by decreased bone density, leading to fragile bones and an increased risk of fractures, particularly in the wrist, spine, and hip. It can be classified into primary osteoporosis, which is often related to aging and menopause, and secondary osteoporosis, caused by identifiable diseases or agents. Risk factors include low body weight, smoking, excessive alcohol use, and certain medical conditions, while prevention involves physical activity, calcium and vitamin D intake, and fall prevention measures.

1. Osteoporosis

2. Definition
• Osteoporosis is a condition
characterized by a decrease in the
density of bone, decreasing its
strength and resulting in fragile
bones.
• Osteoporosis literally leads to
abnormally porous bone that is
compressible, like a sponge.
• This disorder of the skeleton weakens
the bone and results in frequent
fractures (breaks) in the bones
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3. Definition
• Osteoporosis is defined as a
progressive skeletal disorder,
characterised by low bone
mass & microarchitectural
deterioration of bone tissue,
leading to a consequent
increase in bone fragility, &
susceptibility to fracture
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4. Definition
• Fractures of the wrist, spine, and hip are
most commonly involved.
• Fractures of the ribs, humerus and pelvis are
not uncommon.
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5. Definition
Two categories of osteoporosis exist: primary
and secondary osteoporosis.
Primary Osteoporosis
• The most common form of osteoporosis.
• Includes postmenopausal osteoporosis
(type 1) and age-associated osteoporosis
(type 2), formerly termed senile
osteoporosis.
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6. Definition
Secondary Osteoporosis
• Loss of bone is caused by an identifiable agent or
disease process such as an inflammatory disorder,
bone marrow cellularity disorder, and corticosteroid
use.
• steroids decrease the amount of calcium absorbed
by the intestine
• steroids increase calcium excretion through the
kidneys
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7. Risk Factors
National Osteoporosis Foundation
Physician Guidelines for Risk Factors
for Osteoporotic Fracture
• Current cigarette smoking
• Low body weight « 127 pounds)
• Alcoholism – depress osteoblast function
• Estrogen deficiency
• Prolonged amenorrhea (> 1 yr)
• Early menopause «45 yr)
• Lifelong low calcium intake
• Recurrent falls
• Poor health/fragility
• Inadequate physical activity 7Osteoporosis

8. Risk Factors
• In men, excessive drinking reduces
testrosterone. Since testrosterone is
necessary for the work of osteoblasts, it
means that less bone is formed.
• In women, excessive drinking can
interfere with their menstrual cycle.
Irregular periods lead to bone loss
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9. Risk Factors
• Long term use of high dose corticosteroid tablets
for conditions such as RA & asthma – interfere
with the lifespan of the osteogenic cells
• Close family history of osteoporosis
• Medical conditions such thyroid problems
• Hyperthyroidism occurs when the thyroid gland
becomes overactive, & the excess of thyroxine –
causes the rate of remodelling & loss of BMD to
increase
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10. Risk Factors
• Malabsorption problems ( coelic disease, crohn’s
disease, intestinal diseases or gastric surgery - affects
the persons ability to absorb the essential vitamins &
minerals from food
• Eating disorders such as anorexia nervosa, bulimia –
malnourished in calcium – lead to decline in body
function & production of hormones – estrogen –
causing menstruation to cease
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11. Symptoms & Clinical
Features
• Osteoporosis can be present without any
symptoms for decades because
osteoporosis doesn't cause symptoms
until bone fractures.
• Therefore, patients may not be aware of
their osteoporosis until they suffer a
painful fracture.
• The symptom associated with
osteoporotic fractures usually is pain; the
location of the pain depends on the
location of the fracture
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12. Symptoms & Clinical
Features
• Fractures of the spine (vertebra) can cause severe
"band-like" pain that radiates from the back to
the sides of the body.
• Over the years, repeated spinal fractures can
lead to chronic lower back pain as well as loss of
height or curving of the spine due to collapse of
the vertebrae.
• The collapse gives individuals a hunched-back
appearance of the upper back, often called a
"dowager hump" because it commonly is seen in
elderly women
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13. Symptoms & Clinical Features
• A fracture that occurs during the course of normal
activity is called a minimal trauma or stress fracture.
For example, some patients with osteoporosis
develop stress fractures of the feet while walking or
stepping off a curb.
• Hip fractures typically occur as a result of a fall. With
osteoporosis, hip fractures can occur as a result of
accidents.
• Hip fractures also may heal slowly or poorly after
surgical repair because of poor healing of the bone.
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14. Osteoporosis: The Diagnosis
X-Ray Tests
• If you have back pain, your doctor may order an
x ray of your spine to determine whether you
have had a fracture.
• An x ray also may be appropriate if you have
experienced a loss of height or a change in
posture.
• However, because an x ray can detect bone loss
only after 30 percent of the skeleton has been
depleted, the presence of osteoporosis may be
missed
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15. Osteoporosis: The
Diagnosis
BMD test is called a dual-energy x-ray
absorptiometry, or DXA test.
• BMD tests provide doctors with a
measurement called a T-score, a number
value that results from comparing your
bone density to optimal bone density.
• When a T-score appears as a negative
number (such as –1, –2 or –2.5), it indicates
low bone mass. The greater the negative
the number, the greater is the risk of
fracture.
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16. Osteoporosis: The
Diagnosis
Bone Scans
• For some people, the doctor may order a bone scan.
• A bone scan is different from the BMD test, although
the term "bone scan" often is used incorrectly to
describe a bone density test.
• A bone scan involves injecting the patient with a dye
that allows a scanner to identify differences in the
conditions of various areas of bone tissue. A bone
scan can show the doctor changes in bone tissue that
may indicate cancer, bone lesions, inflammation, or
new fractures
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17. Osteoporosis: The Diagnosis
The most common blood tests evaluate:
• blood calcium levels
• blood vitamin D levels
• thyroid function
• parathyroid hormone levels
• To measure estrogen (in women)
• testosterone levels (in men)
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18. Preventive Measures
• Adequate weight-bearing physical activity for
3-4 hr a wk.
• Avoid low body weight or excessive thinness.
• Avoid excess alcohol intake.
• Lifelong appropriate calcium and vitamin D
intake.
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19. Preventive Measures
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20. Adequate calcium intake
guidelines
Life stage group Estimated adequate calcium
intake
Infants –( 6 month)
(6 – 12 Month)
210
270
Young children (1-3yr) 500
Older Children (4-8yr) 1800
Adolescents & young adults
(9-18yr)
1300
Men & women(19-50yr),
above 51yr
1000
1200
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21. Prevention of falls in osteoporotic
patients
• Night lights in bathrooms and hallways.
• Nonskid soles for shoes.
• Nonslip mats under rug.
• Equip tub, shower, and toilet areas with grab bars.
• Rise cautiously from a supine position.
• Ensure stairway rails are sturdy.
• Keep a flashlight by the bedside.
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22. Exercise for osteoporosis
Three types of exercise for osteoporosis are:
• Weight-bearing
• Resistance
• Flexibility
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23. Exercise for osteoporosis
• Exercises designed to prevent or treat
osteoporosis by strengthening your muscles and
bones and improving your posture and
balance.
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