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Osteoporosis
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Osteoporosis is a common clinical syndrome which involves multiple bones in which there is quantitative reduction of bone tissue mass but the bone tissue mass is otherwise normal. This reduction in bone mass results in fragile skeleton, which is associated with increased risk of fractures. There may also be consequent pain and deformity.

Symptoms of Osteoporosis

The condition is mainly common in elderly people. It is most frequently seen in post-meopausal women. The condition may remain asymptomatic or may cause only backache. However, more extensive involvement is associated with fractures, particularly of distal radius, femoral neck and vertebral bodies. Osteoporosis may be difficult to distinguish radiologically from other osteogenesis imperfect, multiple mycloma, etc. Radiologic evidence becomes visible only after more than 30% of bone mass has been lost levels of serum calcium, inorganic phosphorus and alkaline phosphates are usually within normal limits.

Types and Causes of Osteoporosis

Osteoporosis is basically classified into 2 major groups, that is, Primary and Secondary.

It results mainly from osteopenia without an underlying disease or medication. Primary Osteoporosis is further subdivided into 2 types: idiopathic type found in the young and juveniles and is less frequent and involution type seen in postmenopausal women and ageing individuals and is more common. The exact mechanism of primary osteoporosis is not known but it is believed that it results from excessive osteoclastic resorption and slow bone formation. A number of risk factors have been attributed to cause this imbalance between bone resorption and bone formation. These are as follow:-

1) Genetic factors: It is more marked in whites and Asians than blacs.

2) Sex: It is more frequent in frequent in females than in males.

3) Reduced physical activity: As in old age.

4) Deficiency of sex hormones: Oestrogen deficiency in women as in postmenopausal osteoporosis and androgen deficiency in men.

5) Combined deficiency of calcitonin and oestrogen.

6) Hyperparathyroidism: Deficiency of Vitamin D.

7) Local Factors: Which may stimulate osteoclastic resorption or slow osteoblastic bone formation.

It is because of number of factors and conditions. For Example : Immobilization, chronic anaemia, acromegaly, hepatic disease, hyperparathyroidism, hypogonadism, thyrotoxicosis and starvation. It may also occur as an effect of medication for egr hypercortisonism, administration of anticonvulsant drugs and large dose of heparin.

Except disure or immobilization osteoporosis which is localized to the affected limb, other forms of osteoporosis have systemic skeletal distribution. Most commonly seen osteoporotic factures are: Vertebral crush fracture, femoral neck fracture and wrist facture. There is enlargement of the medullary cavity and thinning of the cortex.

Treatment of Osteoporosis

It has been found that infant and childhood, calcium intake may play a major role in the occurrence and severity of the disease in later years. Hence, the treatment of osteoporosis has changed ove the years. Androgen and estrogen therapies have been replaced by increased calcium intake and strontium and sodium fluoride ingestion. The role of strontium and fluoride in bone metabolism is not fully known, but they do act to sustain bone mass in elderly osteoporotic patients, calcium balance can be achieved with a high calcium intake.

Histrologically, Osteoporosis may be of the active or inactive type. Active osteoporosis is characterized by increased bone resorption and formation but passive osteoporosis has the features of minimal bone formation and reduced resorptive activity.




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