OSTEOPOROSIS
The most common bone type of osteoporosis is trabecular bone. The most
common anatomic site is in the vertebral bodies, leading to crush fractures,
kyphosis, and decreased height. Hip and wrist fractures are the next most
frequent sites.
Diagnosis. The most common method of assessing bone density is with a
DEXA scan (dual-energy x-ray absorptiometry). The most common method of
assessing calcium loss is 24-h urine hydroxyproline or NTX (N-telopeptide, a
bone breakdown product).
The most common risk factor is positive family history in a thin, white female.
Other risk factors are steroid use, low calcium intake, sedentary lifestyle,
smoking, and alcohol.
Prevention. Maximum bone density is found in the mid-20s. Maintenance of
bone density is assisted by both lifestyle and medications.
Definition of abbreviations: SERMS, selective estrogen receptor modulators.Lifestyle Ca2+ and vitamin D intake
Weight-bearing exercise
Stop cigarettes and alcohol
Medical Historic gold standard for comparing therapies: estrogen replacement
Inhibit osteoclasts: bisphosphonates (alendronate, risedronate)
Increase bone density: SERMs (raloxifene)