Osteoporosis

is characterised by reduction in bone mass per unit volume to a level below that required for adaquate mechanical support.
There is no abnormality in ratio of the mineral to organic phase of bone matrix.
It is also defind as bone density that fall 2.5 standard deviation below the mean for that population.
Causes_
1 nutritional n git disordes_malnutrition,malabsorption syndrome,severe liver disease.
2 endocrine disorde_cushing syndrome,thyrotoxicosis.
3 inherited disorder_osteogenesis imperfecta,marfan syndrome,porphyria.
4 drugs_chronic steroid therapy.
5 rheumatoid arthritis,ankylosing spondylitis
clinial features_
fracture is only cause of symptoms in osteoporosis which produce sudden pain.Common site of fracture include spine,hip n wrist jt.
Lab investigations_
1 sr calcium,alkaline phosphatase,urine calcium.
2 urinary lever of cross linked N-telopeptide of type 1 collagen more than 40nmol/L indicate excessive bone turnover n is feature of osteoporosis.
3 radiograph of spine n pelvis
reduce cortical thickness of bones,increase radiolucency of bone.Vertebra show Codfish appearance.
4 measurement of bone density by ct scan,ultrasound n DEXA scan.
Treatment_
1 diet should include at least 1 g of calcium n 400_800 IU of vit D.
2 ensure adaquate wt bearing exersices.
3 smoking n alcohol should b stopped
4 reduce fall by taking care of home safety n personal precautions.
5 if steroids r required for chroic use,addition of calcium, vit D n bisphonates.