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Osteoporosis

What is it?

It is a condition that causes bones to become weak and brittle and hence prone to fracture.

What are the consequences of osteoporosis?

Fractures. The typical osteoporosis fractures are the following: wrist, spine, arm and hip fractures. Many patients with

osteoporosis suffer the following: a fragility fracture or low-trauma fracture. That is, the fracture that they have sustained is due to a force that is not sufficient enough to justify the fracture. Sometimes, a fracture might be sustained even when there is no trauma eg when sneezing.
How do you diagnose osteoporosis?

The following can be used to diagnose osteoporosis:

  • a low trauma fracture – this is the clinical diagnosis of osteoporosis
  • a bone mineral density
What are the management principles of osteoporosis:
  • Diagnosis of the disease
  • Assessment to ensure that there are no other causes of osteoporosis - if there are to treat these causes. Examples of secondary causes are - hormonal causes such as too high thyroid levels (hyperthyroidism), too high parathyroid hormone levels that may cause an increased bone breakdown and leading to weak bone.
  • Discussion and decision making on the most appropriate medication for the condition
  • Ensuring optimal calcium and vitamin D intake daily
  • Lifestyle changes to decrease fall risk
  • On starting the chosen medication, to ensure proper follow-up with accurate interpretation of the findings that are obtained in the various bone mineral densities.
What are the various classes of medications for osteoporosis

Drugs that decrease bone breakdown:

  • Bisphosphonates – oral and injectables
  • RANK ligand inhibitor – 6 monthly injections Drugs that increase bone formation
  • Teriparatide
Myths of osteoporosis
  • Men do not get osteoporosis – 1 in 5 men over the age of 50 suffer from osteoporotic fracture compared to 1 in 3 women
  • Osteoporosis is painful – it is silent
  • Calcium and vitamin D is sufficient to cure osteoporosis – this is not true and if the patient is osteoporotic then they will need treatment with medications