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
