What is Osteoporosis?
Consensus 93: It is a systemic disease characterized by low bone density and insufficiency of microstructures, which increases the fragility and fracture risk in bone tissue.
What is Osteoporosis? Definition 2002 (USNIH): It is a skeletal disease characterized by an increased risk of fracture as a result of impaired bone strength. Bone strength is the reflection of two main components of bone: bone density and quality.
Risk factors:
Majör | Minör |
-Age> 65 | -Rheumatoid Arthritis |
-Vertebral Fracture | -Hyperthyroidism story |
-Fracture after age 40 | -Chronic use of anticonvulsant or heparin |
-Family story | -Calcium-poor diet |
-Glucocorticoid therapy | -Smoking, Alcoholism |
-Malabsorption | -Caffeine |
-First Hyperparathyroidism | -<57 kg and weight loss> (more than 10% -of 25-year-old weight) |
-Tendency to fall | |
-X-ray osteopenia | |
-Hypogonadism | |
Other risks:
-General muscle weakness
-Difficulty in balancing (neurological, vestibular, ophthalmological problems)
-Vision defect
-Slow walking
-Disruption of heel-toe gait (arthrodeses etc.)
Who should be made a risk inquiry?
- Everyone over the age of 50 should be questioned
-The main areas at risk of fracture (wrist, humerus, ribs, vertebra, pelvis and hip) should be examined in detail.
Who should be taken for Osteoporosis tests?
- Those with height shortening> 4 cm
-Progressive kyphosis (hump)
-Long-term steroid users
-Those with low-energy post-traumatic fractures
-Patients> 65 years old
-Those under the age of 65 who have clinical risk should be included in the investigation.
Who are at high risk?
-The main skeletal fracture
-Those who have developed kyphosis
-With a shortening of height
-One Major and two Minor factors detected
-Those with low bone density have a high risk of fractures.
What are the normal values in bone density densitometry?
-Normal BMD; T score according to the standard deviation of the mean bone density of young adults: those in the range of +2.5 - (- 1.0).
-Osteopenia; T: (- 1) - (- 2.5) Grade-C
-Osteoporosis; T <minus 2.5 Grade-B
-Group A at risk of osteoporosis and fractures
Who should be treated?
-Those at high risk of fractures
-Those taking glucocorticoid therapy for a long time
-Those who had fractures and low bone density after low-energy trauma are treated immediately.