By hamidreza soltanian8533047

Osteoporosis is a Greek word meaning porous bone.

While osteoporosis is mostly seen in women (80 %), it can occur at any age and gender depending on some risk factors.

About 50 % of women having osteoporotic fracture require long term care.

Bone tissue is under the exposure of excessive stress during daily activities.

Excessive osteoclast or insufficient osteoblast number causes improper filling of resorption site and this leads to low bone mass.

Women in their postmenopausal stage are in the highest risk group of osteoporosis.

ERT,HRT

MODIFIABLE FACTORS

Smoking Excessive alcohol

consumption anticonvulsants usage Low Ca,Vitamin D diet Estrogen lacking Low body weight (<43

kg) Sedentary lifestyle

UNMODIFIABLE FACTORS

Personal fracture history

Fracture history in family

Elder age History of organ

transplants Connective tissue

disorders Hormonal disorders

Back pain Height loss Neck strain FracturesBody deformation

Dual energy X-ray absorptiometry (DEXA) and quantitative computed micro tomography (QCT) measurements are done from central site.

BMD testing compares the patient’s BMD measurement with young man’s BMD value.

The standard deviation (SD) of the patient’s BMD result from the mean is computed.SITUATION T SCORE STANDARD

DEVIATION (SD)

Normal T > -1 Less than 1

Osteopenia (low bone mass)

-2.5 < T < -1 Between 1 and 2.5

Osteoporosis T < -2.5 More than 2.5

Serious osteoporosis {T< -2.5 } + {having 1 or more fractures}

More than 2.5 + having one or more fractures

ADVANTAGES DISADVANTAGES

Low amount of radiation exposure, fast, effective in serial applications, inexpensive, regularly updated with new software

Osteoarthritis may cause an overestimated result, should be corrected by an expertised operator

Most sensitive, can make 3D analysis, many application sites

Large amount of radiation exposure, ineffective in serial applications, expensive

No radiation exposure , cheapest, fast, portable, usable in office environment

Limited application sites, limited accuracy

Dual energy X -ray absorptiometry (DEXA)

Quantitative computerized tomography (QCT)

Heel ultrasound (HUS)

ADVANTAGES DISADVANTAGES

Cheap, effective in serial screening applications

Oldest technique, limited application areas, radiation exposure, can give a general idea if there is a huge amount of bone loss like 40-50%

No radiation exposure, fast, can directly supply ideas about the risk factors

Does not give a quantity value to make comparison, not accurate and may lead to wrong diagnosis if the physician is not expertised.

Reveals the metabolic sources of osteoporosis if there is any

High degree of biologic variability

X- ray

Physical examination

Chemical evaluation of serum and bone markers

Is a means of measuring bone mineral density (BMD).

Two X-ray beams with differing energy levels are aimed at the patient's bones.

Dual energy X-ray absorptiometry (DXA) is the most widely used and most thoroughly studied bone density measurement technology.

DXA scans can also be used to measure total body fat content.

Special considerations are involved in the use of DXA to assess bone mass in children.

Z-score Also, there are other variables in addition

to age which are suggested to confound the interpretation of BMD as measured by DXA.

How to correct it?!(BMAD) DXA is, by far, the most widely used

technique for bone measurements.