Osteoporosis

 

 Osteoporosis

 ·        Osteoporosis is a bone thinning disease that makes the bones fragile.

·        It affects elderly women.

·        The most important risk factor for osteoporosis and its related fracture in women is menopause. There is reaped reduction of estrogen levels in women at menopause. This leads to a faster rate of bone loss.

·        As there are no signs until a fracture occurs, osteoporosis is not detected early.

Bone Densitometry

Conventional radiographs are readily available and fairly inexpensive.  However, estimation of spinal bone mineral density (BMD) from appearances on conventional radiographs is insensitive and inaccurate if vertebral fractures are not present. The subjective assessment is influenced by the radiographic exposure factors, patient size, and film processing techniques. BMD must decline by as much as 35% before it can be detected on radiographs. These factors have supported the need for objective, noninvasive methods of bone density measurements. Current techniques include radiographic absorptiometry (RA), single x-ray absorptiometry (SXA), and dual energy x-ray absorptiometry (DEXA).

Dual energy x-ray absorptiometry (DEXA)

The fundamental physical principle behind DEXA is the simultaneous measurements of x-rays with two different energies through the body. The main advantages of DEXA are a shortened examination time, greater accuracy and precision. The preferred anatomic sites for DEXA measurements of bone mineral include the lumber spine (L₁-₄), the proximal end of femur, (neck, trochantre, Wards triangle and total hip), and the whole body. A more recent development in DEXA technology has been the introduction of a new generation of fan-beam scanners such as the Hologic QDR 4500 and the Lunar Expert –XL. The instrument installed here is a Hologic QDR 4500. The advantage of fan-beam system is its higher image resolution, which allows easier identification of vertebral structures and artifacts caused by degenerative disease. Low radiation dose, availability, and ease of use have made DEXA the most widely used technique for measurement of bone mineral density.

Osteoporosis

Osteoporosis is defined as a  systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to low trauma or atraumatic fractures. Fractures, specially those of the spine hip and wrist are the clinical complications of osteoporosis. The most serious fractures are those of hip which contribute substantially to morbidity, mortality. Bone mass is the most important determinant of bone. strength. Reduced bone mass is a useful predictor of increased fracture risk.

Who are at risk for osteoporosis

1.     Perimenopausal

2.     Endocrine disorders.

a)     Hyperthyroidism

b)     Hyperparathyroidism

c)      Type –I diabetes mellitus

3.     Conditions associated with hypogonadism

4.     Inflammatory disorders

a)     Rheumatoid arthritis

b)     Ankylosing spondylitis

c)      Lupus erythematosus

5.     Disorders associated with malabsorption

6.     Bone marrow disorders

a)     Multiple myeloma

b)     Leukemia

7.     Disorders of connective tissue

8.     Drugs

a)     Corticosteroids

b)     Thyroxine

c)      Anti-convalsants

 Prevention

·        Good food and exercise during childhood and adult year.

·        Adequate intake of minerals, specially calcium and vitamins.

·        Replacement of estrogen after menopause can help.

·        X rays/ Bone density measurement help to diagnose osteoporosis early.

You can detect osteoporosis even before a fracture occurs, simply by measuring your bone density by a special machine, which is as easy as on X- ray.