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Pathology

Low bone mass leading to increased fragility and fractures.
Bone undergoes a continual process of resorption and formation, bone loss results from an imbalance between the rates of those processes

Aetiology

Primary:
Type I osteoporosis (postmenopausal osteoporosis) occurs in women aged 50-65 years
Type II osteoporosis (age-associated or senile) occurs in women and men older than 70 years
Secondary: Endocrine (Cushing syndrome, adrenal insufficiency), multiple 
 myeloma, corticosteroids, renal failure, alcoholism, reduced physical 
 activity

Signs

Fracture 

Symptoms

Osteoporosis is typically asymptomatic until a fracture occurs 

Investigations

Bloods: Calcium, phosphate, ALP all normal
Imaging: Chest X-Ray: Wedge fractures in vertebrae
DEXA Scan: Assess Bone Mineral Density by calculating T Scorer which compares bone density to peers.
T-Score >-1 normal
T-Score -1 to -1.5 osteopenia
T-Score < -2.5 osteoporosis

Treatment

Conservative: Exercise, stop smoking, improved diet
Medical: Calcium, vitamin D, bisphosphonates, oestrogen and calcitonin

Prognosis

Good prognosis if detected early
Fractures

Key Facts

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Key Images

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Key References

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