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Encyclopedia > Osteoporosis
Osteoporosis
Classification and external resources
ICD-10 M80.-M82.
ICD-9 733.0
OMIM 166710
DiseasesDB 9385
MedlinePlus 000360
eMedicine med/1693  ped/1683 pmr/94 pmr/95
MeSH D010024

Osteoporosis is a disease of bone that leads to an increased risk of fracture. In osteoporosis the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old healthy female average) as measured by DXA; the term "established osteoporosis" includes the presence of a fragility fracture.[1] Osteoporosis is most common in women after menopause, when it is called postmenopausal osteoporosis, but may also develop in elderly men, and may occur in anyone in the presence of particular hormonal disorders and other chronic diseases or as a result of medications, specifically glucocorticoids, when the disease is called steroid- or glucocorticoid-induced osteoporosis (SIOP or GIOP). Given its influence on the risk of fragility fracture, osteoporosis may significantly affect life expectancy and quality of life. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... This article is about the medical term. ... This article is about the skeletal organs. ... Internal and external views of an arm with a compound fracture, both before and after surgery A bone fracture is a medical condition in which a bone has cracked or broken. ... A bone mineral density (BMD) test, also called a bone mass measurement, is used to measure bone density and determine fracture risk for osteoporosis. ... Tropocollagen triple helix. ... WHO redirects here. ... In probability and statistics, the standard deviation of a probability distribution, random variable, or population or multiset of values is a measure of statistical dispersion of its values. ... A scanner used to measure bone density with dual energy X-ray absorptiometry. ... A fragility fracture is one that occurs as a result of a fall from standing height or less. ... The word menopause literally means the permanent physiological, or natural, cessation of menstrual cycles, from the Greek roots meno (month) and pausis (a pause, a cessation). ... In medicine, a chronic disease is a disease that is long-lasting or recurrent. ... A medication is a drug or substance taken to reduce symptoms or cure an illness or medical condition. ... Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... This article is about the measure of remaining life. ... Quality of life is the degree of well-being felt by an individual or group of people. ...


Osteoporosis can be prevented with lifestyle advice and sometimes medication, and in people with osteoporosis treatment may involve lifestyle advice, preventing falls and medication (calcium, vitamin D, bisphosphonates and several others). Calcium (Ca2+) plays a vital role in the anatomy, physiology and biochemistry of organisms and of the cell, particularly in signal transduction pathways. ... Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ... In pharmacology, bisphosphonates (also called: diphosphonates) is a class of drugs that inhibits the resorption of bone. ...

Contents

Signs and symptoms

Osteoporosis itself has no specific symptoms; its main consequence is the increased risk of bone fractures. Osteoporotic fractures are those that occur in situations where healthy people would not normally break a bone; they are therefore regarded as fragility fractures. Typical fragility fractures occur in the vertebral column, hip and wrist. In medicine, a disease is asymptomatic when it is at a stage where the patient does not experience symptoms. ... Wikipedia does not yet have an article with this exact name. ... A fragility fracture is one that occurs as a result of a fall from standing height or less. ... The vertebral column seen from the side Different regions (curvatures) of the vertebral column The vertebral column (backbone or spine) is a column of vertebrae situated in the dorsal aspect of the abdomen. ... A hip fracture is a fracture in the proximal end of the femur (the long bone running through the thigh), near the hip joint. ... For the municipality in Germany, see Wrist, Germany. ...


Fractures

The symptoms of a vertebral collapse ("compression fracture") are sudden back pain, often with radiculopathic pain (shooting pain due to nerve compression ) and rarely with spinal cord compression or cauda equina syndrome. Multiple vertebral fractures lead to a stooped posture, loss of height, and chronic pain with resultant reduction in mobility.[2] A diagram of a thoracic vertebra. ... A compression fracture is a collapse of a vertebra. ... Back pain (also known dorsalgia) is pain felt in the back that may originate from the muscles, nerves, bones, joints or other structures in the spine. ... Radiculopathy is not a specific condition, but rather a description of a problem in which one or more nerves are affected and do not work properly. ... For other uses, see Nerve (disambiguation). ... Spinal cord compression develops when the spinal cord is compressed by a tumor, abscess or other lesion. ... Cauda equina syndrome is a serious neurologic condition in which there is compression of the vertebral column (spine) affecting the S1-S4 nerve roots. ...


Fractures of the long bones acutely impair mobility and may require surgery. Hip fracture, in particular, usually requires prompt surgery, as there are serious risks associated with a hip fracture, such as deep vein thrombosis and a pulmonary embolism, and increased mortality. “Surgeon” redirects here. ... A hip fracture is a fracture in the proximal end of the femur (the long bone running through the thigh), near the hip joint. ... This article is about Deep-vein thrombosis. ...


Falls risk

The increased risk of falling associated with aging leads to fractures of the wrist, spine and hip. The risk of falling, in turn, is increased by impaired eyesight due to any cause (e.g. glaucoma, macular degeneration), balance disorder, movement disorders (e.g. Parkinson's disease), dementia, and sarcopenia (age-related loss of skeletal muscle). Collapse (transient loss of postural tone with or without loss of consciousness) leads to a significant risk of falls; causes of syncope are manifold but may include cardiac arrhythmias (irregular heart beat), vasovagal syncope, orthostatic hypotension (abnormal drop in blood pressure on standing up) and seizures. Removal of obstacles and loose carpets in the living environment may substantially reduce falls. Those with previous falls, as well as those with a gait or balance disorder, are most at risk.[3] Listen to this article ( info/dl) This audio file was created from an article revision dated 2005-07-19, and may not reflect subsequent edits to the article. ... Balance is the result of a number of body systems working together. ... List of Movement disorders Akinesia (lack of movement) Athetosis (contorted torsion or twisting) Ataxia Ballismus (violent involuntary rapid and irregular movements) Hemiballismus Bradykinesia (slow movement) Chorea (rapid, involuntary movement) Sydenhams chorea Rheumatic chorea Huntingtons chorea Dystonia (sustained torsion) Dystonia muscularum Blepharospasm Writers cramp Spasmodic torticollis (twisting of... For other uses, see Dementia (disambiguation). ... Please wikify (format) this article as suggested in the Guide to layout and the Manual of Style. ... A top-down view of skeletal muscle Skeletal muscle is a type of striated muscle, usually attached to the skeleton. ... Collapse is a sudden and often unannounced loss of postural tone (going weak), often but not necessarily accompanied by loss of consciousness. ... Cardiac arrhythmia is any of a group of conditions in which the electrical activity of the heart is irregular or is faster or slower than normal. ... Vasovagal syncope is the most common cause of syncope, also known as fainting. ... Orthostatic hypotension (also known as postural hypotension, orthostatic intolerance and, colloquially, as head rush or a dizzy spell) is a sudden fall in blood pressure, typically greater than 20/10 mm Hg, that occurs when a person assumes a standing position, usually after a prolonged period of rest. ... This article is about epileptic seizures. ...


Risk factors

Risk factors for osteoporotic fracture can be split between non-modifiable and (potentially) modifiable. In addition, there are specific diseases and disorders in which osteoporosis is a recognized complication. Medication use is theoretically modifiable, although in many cases the use of medication that increases osteoporosis risk is unavoidable.


Nonmodifiable

The most important risk factors for osteoporosis are advanced age (in both men and women) and female sex; estrogen deficiency following menopause is correlated with a rapid reduction in BMD, while in men a decrease in testosterone levels has a comparable (but less pronounced) effect. While osteoporosis occurs in people from all ethnic groups, European or Asian ancestry predisposes for osteoporosis.[4] Those with a family history of fracture or osteoporosis are at an increased risk; the heritability of the fracture as well as low bone mineral density are relatively high, ranging from 25 to 80 percent. There are at least 30 genes associated with the development of osteoporosis.[5] Those who have already had a fracture are at least twice as likely to have another fracture compared to someone of the same age and sex.[6] For other uses, see Female (disambiguation). ... Estriol. ... The word menopause literally means the permanent physiological, or natural, cessation of menstrual cycles, from the Greek roots meno (month) and pausis (a pause, a cessation). ... Testosterone is a steroid hormone from the androgen group. ... The European peoples are the various nations and ethnic groups of Europe. ... Asian people[1] is a demonym for people from Asia. ... In medicine, a family history consists of information about disorders that a patients direct blood relatives have suffered from. ... In genetics, heritability is the proportion of phenotypic variation in a population that is attributable to genetic variation among individuals. ...


Potentially modifiable

  • Excess alcohol - small amounts of alcohol do not increase osteoporosis risk and may even be beneficial, but chronic heavy drinking(Alcohol intake greather than ≥ 3 units/day)[7], especially at a younger age, increases risk significantly.[8]
  • Vitamin D deficiency[9] - low circulating Vitamin D is a common among the elderly world wide.[10] Mild vitamin D insufficiency is associated with increased Parathyroid Hormone (PTH) production. [10] PTH increases bone reabsorption, leading to boneloss. A positive association exists between serum 1,25-dihydroxycholecalciferol levels and bone mineral density, whilst PTH is negatively associated with bone mineral density. [10]
  • Tobacco smoking - tobacco smoking inhibits the activity of osteoblasts, and is an independent risk factor for osteoporosis.[7][11] Smoking also results in increased breakdown of exogenous oestrogen, lower body weight and earlier menopause, all of which contribute to lower bone mineral density.[10]
  • Low body mass index - being overweight protects against osteoporosis, either by increasing load or through the hormone leptin.[12]
  • Malnutrition - low dietary calcium intake, low dietary intake of vitamins K and vitamin c [9] Also low protien intake is associated with lower peak bone mass during adolescence and lower bone mineral density in elderly populations. [10]
  • Physical inactivity - bone remodeling occurs in response to physical stress. Weight bearing exercise can increase peak bone mass achieved in adolescence. [10] In adults, physical activity helps maintain bone mass, and can increase it by 1 or 2%.[citation needed] Conversely, physical inactivity can lead to significant boneloss. [10]
  • Excess physical activity - excessive exercise can lead to constant damages to the bones which can cause exhaustion of the structures as described above. There are numerous examples of marathon runners who developed severe osteoporosis later in life. In women, heavy exercise can lead to decreased estrogen levels, which predisposes to osteoporosis. Intensive training is often associated with low body mass index.[citation needed]
  • Heavy metals - a strong association between cadmium, lead and bone disease has been established. Low level exposure to cadmium is associated with an increased loss of bone mineral density readily in both genders, leading to pain and increased risk of fractures, especially in elderly and in females. Higher cadmium exposure results in osteomalacia (softening of the bone).[13]
  • Soft drinks - some studies indicate that soft drinks (many of which contain phosphoric acid) may increase risk of osteoporosis;[14] others suggest soft drinks may displace calcium-containing drinks from the diet rather than directly causing osteoporosis.[15]

Booze redirects here. ... RNA expression pattern Orthologs Human Mouse Entrez Ensembl Uniprot na Refseq Location Pubmed search Parathyroid hormone (PTH), or parathormone, is secreted by the parathyroid glands as a polypeptide containing 84 amino acids. ... The cigarette is the most common method of smoking tobacco. ... Look up body mass index in Wiktionary, the free dictionary. ... RNA expression pattern Orthologs Human Mouse Entrez Ensembl Uniprot Refseq Location Pubmed search Leptin (from the Greek word leptos, meaning thin) is a 16 kDa protein hormone that plays a key role in regulating energy intake and energy expenditure, including the regulation (decrease) of appetite and (increase) of metabolism. ... Percentage of population affected by malnutrition by country, according to United Nations statistics. ... For other uses, see Calcium (disambiguation). ... U.S. Marine emerging from the swim portion of a triathlon. ... In orthopedics Weight bearing the weight a patient puts on the leg on which surgery has been performed, and is referred to as part of the body weight, since each leg of a healthy person carries alternately the full body weight when walking. ... For other uses, see Heavy metal (disambiguation). ... General Name, Symbol, Number cadmium, Cd, 48 Chemical series transition metals Group, Period, Block 12, 5, d Appearance silvery gray metallic Standard atomic weight 112. ... Osteomalacia is a softening of the bones, resulting from defective bone mineralisation. ... A soft drink is a drink that contains no alcohol. ... This article is about orthophosphoric acid. ...

Diseases and disorders

Many diseases and disorders have been associated with osteoporosis.[16] For some, the underlying mechanism influencing the bone metabolism is straight-forward, whereas for others the causes are multiple or unknown. Image File history File links Question_book-3. ...

Immobilization in soil science, is when organic matter decomposes and is absorbed by micro-organisms, therefore preventing it being accessible to plants [1]. Immobilization is the alternative to mineralization. ... Currently, the most common technology for space transport is rocket propulsion, which expels matter to provide a net forward thrust. ... Hypogonadism is a medical term for a defect of the reproductive system which results in lack of function of the gonads (ovaries or testes). ... XXY karyotype Klinefelters syndrome is a condition caused by a chromosome abnormality in males (specifically, a nondisjunction); sufferers have a pair of X sex chromosomes instead of just one. ... Kallmann syndrome is an example of hypogonadism (decreased functioning of the sex hormone-producing glands) caused by a deficiency of gonadotropin-releasing hormone (GnRH), which is created by the hypothalamus. ... For other uses, see Anorexia. ... The hypothalamus links the nervous system to the endocrine system via the pituitary gland (hypophysis). ... Amenorrhoea (BE) or amenorrhea (AmE) is the absence of a menstrual period in a woman of reproductive age. ... Prolactin is a hormone secreted by lactotropes in the adenohypophysis (anterior pituitary gland) which is made up of 199 amino acids with a molecular weight of about 23,000 daltons. ... Estriol. ... The word menopause literally means the permanent physiological, or natural, cessation of menstrual cycles, from the Greek roots meno (month) and pausis (a pause, a cessation). ... Oophorectomy is the surgical removal of the ovaries of a female animal. ... Premature Ovarian Failure (POF) is the cessation of menstrual periods and ovulation in women under the age of 40. ... Testosterone is a steroid hormone from the androgen group. ... Human male anatomy The testicles, known medically as testes (singular testis), are the male generative glands in animals. ... Hyperparathyroidism is overactivity of the parathyroid glands resulting in excess production of parathyroid hormone (PTH). ... Hyperthyroidism (thyrotoxicosis or fast thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) and free triiodothyronine (T3), or both. ... This article or section does not cite its references or sources. ... For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... Acromegaly (from Greek akros high and megas large - extremities enlargement) is a hormonal disorder that results when the pituitary gland produces excess growth hormone (hGH). ... In medicine, adrenal insufficiency (or hypocortisolism) is the inability of the adrenal gland to produce adequate amounts of cortisol in response to stress. ... This article is about human pregnancy in biological females. ... Kittens nursing Lactation describes the secretion of milk from the mammary glands, the process of providing that milk to the young, and the period of time that a mother lactates to feed her young. ... Percentage of population affected by malnutrition by country, according to United Nations statistics. ... Total parenteral nutrition (TPN), also called hyperalimentation, is the practice of feeding a person without using the gut. ... Malabsorption is the state of impaired absorption of nutrients in the small intestine. ... Coeliac disease (pronounced ), also spelt celiac disease, is an autoimmune disorder of the small bowel that occurs in genetically predisposed people of all ages from middle infancy. ... Crohns disease (also known as regional enteritis) is a chronic, episodic, inflammatory bowel disease (IBD) and is generally classified as an autoimmune disease. ... Diagram of the stomach, showing the different regions. ... A bowel resection is a surgical procedure in which a part of the large or small intestine is removed. ... The liver is an organ in vertebrates including humans. ... This article or section does not cite its references or sources. ... Bulimia nervosa, more commonly known as bulimia, is a psychological condition in which the subject engages in recurrent binge eating followed by intentionally doing one or more of the following in order to compensate for the intake of the food and prevent weight gain: vomiting inappropriate use of laxatives, enemas... Vitamin K1 (phylloquinone). ... B12 deficiency can potentially cause severe and irreversible damage, especially to the brain and nervous system. ... Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. ... This article does not deal with the more general topic of childhood arthritis. ... Renal failure is when the kidneys fail to function properly. ... Multiple myeloma (also known as MM, myeloma, plasma cell myeloma, or as Kahlers disease after Otto Kahler) is a type of cancer of plasma cells which are immune system cells in bone marrow that produce antibodies. ... This article is about lymphoma in humans. ... Leukemia or leukaemia (Greek leukos λευκός, white; aima αίμα, blood) is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation (production by multiplication) of blood cells, usually white blood cells (leukocytes). ... In medicine, mastocytosis is a group of rare disorders of both children and adults caused by the presence of too many mast cells (mastocytes) in a persons body. ... Haemophilia or hemophilia is the name of any of several hereditary genetic illnesses that impair the bodys ability to control bleeding. ... sickle cell redirects here. ... Thalassemia (British spelling, thalassaemia) is an inherited autosomal recessive blood disease. ... Osteogenesis imperfecta (OI and sometimes known as Brittle Bone Disease) is a genetic bone disorder. ... Marfan syndrome is an autosomal dominant genetic disorder of the connective tissue characterized by disproportionately long limbs, long thin fingers, a typically tall stature, and a predisposition to cardiovascular abnormalities, specifically those affecting the heart valves and aorta. ... Haemochromatosis, also spelled hemochromatosis, is a hereditary disease characterized by improper processing by the body of dietary iron which causes iron to accumulate in a number of body tissues, eventually causing organ dysfunction. ... Hypophosphatasia is a rare inherited metabolic disease of decreased tissue nonspecific alkaline phosphatase (TNSALP) and defective bone mineralization. ... Glycogen storage disease is any one of several inborn errors of metabolism that result from enzyme defects that affect the processing of glycogen synthesis or breakdown within muscles, liver, and other cell types. ... Homocystinuria, also known as Cystathionine beta synthase deficiency, is inherited disorder of the metabolism of the amino acid methionine. ... Ehlers-Danlos syndrome is a group of rare genetic disorders affecting humans and domestic animals caused by a defect in collagen synthesis. ... Porphyrias are a group of inherited or acquired disorders of certain enzymes in the heme biosynthetic pathway (also called porphyrin pathway). ... Menkes disease, also called the kinky hair disease or Menkes kinky hair syndrome, is a disease of abnormal copper metabolism. ... Gauchers disease (IPA: ) is the most common of the lysosomal storage diseases. ... Idiopathic means arising spontaneously or from an obscure or unknown cause. ... Complex Regional Pain Syndrome (CRPS) is a chronic progressive disease characterized by severe pain, swelling and changes in the skin. ... For COPD occurring in horses, see recurrent airway obstruction. ...

Medication

Certain medications have been associated with an increase in osteoporosis risk; only steroids and anticonvulsants are classically associated, but evidence is emerging with regard to other drugs.

  • Steroid-induced osteoporosis (SIOP) arises due to use of glucocorticoids - analogous to Cushing's syndrome and involving mainly the axial skeleton. The synthetic glucocorticoid prescription drug prednisone is a main candidate after prolonged intake. Some professional guidelines recommend prophylaxis in patients who take the equivalent of more than 30 mg hydrocortisone (7.5 mg of prednisolone), especially when this is in excess of three months.[19] Alternate day use may not prevent this complication.[20]
  • Barbiturates, phenytoin and some other enzyme-inducing antiepileptics - these probably accelerate the metabolism of vitamin D. [21]
  • L-Thyroxine over-replacement may contribute to osteoporosis, in a similar fashion as thyrotoxicosis does.[16] This can be relevant in subclinical hypothyroidism.
  • Several drugs induce hypogonadism, for example aromatase inhibitors used in breast cancer, methotrexate and other anti-metabolite drugs, depot progesterone and gonadotropin-releasing hormone agonists.
  • Anticoagulants - long-term use of heparin is associated with a decrease in bone density,[22] and warfarin (and related coumarins) have been linked with an increased risk in osteoporotic fracture in long-term use.[23]
  • Proton pump inhibitors - these drugs inhibit the production of stomach acid; it is thought that this interferes with calcium absorption.[24] Chronic phosphate binding may also occur with aluminum-containing antacids.[16]
  • Thiazolidinediones (used for diabetes) - rosiglitazone and possibly pioglitazone, inhibitors of PPARγ, have been linked with an increased risk of osteoporosis and fracture.[25]
  • Chronic lithium therapy has been associated with osteoporosis.[16]

Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... Prednisone is a synthetic corticosteroid drug which is usually taken orally but can be delivered by intramuscular injection and can be used for a great number of different conditions. ... Barbituric acid, the basic structure of all barbiturates Barbiturates are drugs that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Phenytoin sodium (marketed as Dilantin® in the USA and as Epanutin® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), are tyrosine-based hormones produced by the thyroid gland. ... Hyperthyroidism (thyrotoxicosis or fast thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) and free triiodothyronine (T3), or both. ... Hypogonadism is a medical term for a defect of the reproductive system which results in lack of function of the gonads (ovaries or testes). ... Aromatase inhibitors (AI) are a class of drugs used in the treatment of breast cancer in postmenopausal women that block the aromatase enzyme. ... Amethopterin redirects here. ... This article is about the contraceptive injection. ... A gonadotropin-releasing hormone agonist (GnRH agonist) is a synthetic peptide modeled after the hypothalamic neurohormone GnRH that interacts with its receptor to elicit its biologic response, the release of the pituitary hormones FSH and LH. Agonists do not quickly dissociate from the GnRH receptor. ... An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ... Warfarin (also known under the brand names of Coumadin, Jantoven, Marevan, and Waran) is an anticoagulant medication that is administered orally or, very rarely, by injection. ... Proton pump inhibitors are a group of drugs whose main action is pronounced and long-lasting reduction of gastric acid production. ... Gastric acid is, together with several enzymes and the intrinsic factor, one of the main secretions of the stomach. ... A phosphate, in inorganic chemistry, is a salt of phosphoric acid. ... Aluminum is a soft and lightweight metal with a dull silvery appearance, due to a thin layer of oxidation that forms quickly when it is exposed to air. ... An antacid is any substance that counteracts stomach acidity. ... The medication class of thiazolidinedione was introduced in the late 1990s as an adjunctive therapy for diabetes mellitus (type II) and related diseases. ... Rosiglitazone is an anti-diabetic drug from the thiazolidinedione class. ... Pioglitazone is a prescription drug of the class thiazolidinedione with hypoglycemic (antihyperglycemic, antidiabetic) action. ... This article is about the chemical element. ...

Diagnosis

A scanner used to measure bone density with dual energy X-ray absorptiometry.
A scanner used to measure bone density with dual energy X-ray absorptiometry.

The diagnosis of osteoporosis is made on measuring the bone mineral density (BMD). The most popular method is dual energy X-ray absorptiometry (DXA or DEXA). In addition to the detection of abnormal BMD, the diagnosis of osteoporosis requires investigations into potentially modifiable underlying causes; this may be done with blood tests and X-rays. Depending on the likelihood of an underlying problem, investigations for cancer with metastasis to the bone, multiple myeloma, Cushing's disease and other above mentioned causes may be performed. A scanner used to measure bone density with dual energy X-ray absorptiometry. ... A bone mineral density (BMD) test, also called a bone mass measurement, is used to measure bone density and determine fracture risk for osteoporosis. ... Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... For the musical composition, see Metastasis (Xenakis composition). ... Multiple myeloma (also known as MM, myeloma, plasma cell myeloma, or as Kahlers disease after Otto Kahler) is a type of cancer of plasma cells which are immune system cells in bone marrow that produce antibodies. ... Cushings syndrome or hypercortisolism is an endocrine disorder caused by excessive levels of the endogenous corticosteroid hormone cortisol. ...


Dual energy X-ray absorptiometry

Dual energy X-ray absorptiometry (DXA, formerly DEXA) is considered the gold standard for the diagnosis of osteoporosis. Osteoporosis is diagnosed when the bone mineral density is less than or equal to 2.5 standard deviations below that of a young adult reference population. This is translated as a T-score. The World Health Organization has established the following diagnostic guidelines:[1][10] A scanner used to measure bone density with dual energy X-ray absorptiometry. ... In medicine, a gold standard test is the diagnostic test that is regarded as definitive in determining whether an individual has a disease process. ... A bone mineral density (BMD) test, also called a bone mass measurement, is used to measure bone density and determine fracture risk for osteoporosis. ... A bone mineral density (BMD) test, also called a bone mass measurement, is used to measure bone density and determine fracture risk for osteoporosis. ... WHO redirects here. ...

  • T-score -1.0 or greater is "normal"
  • T-score between -1.0 and -2.5 is "low bone mass" (or "osteopenia")
  • T-score -2.5 or below is osteoporosis

When there has also been an osteoporotic fracture (also termed "low trauma-fracture" or "fragility fracture"), defined as one that occurs as a result of a fall from a standing height, the term "severe or established" osteoporosis is used.[1] A bone mineral density (BMD) test, also called a bone mass measurement, is used to measure bone density and determine fracture risk for osteoporosis. ... Osteopenia is a decrease in bone mineral density that can be a precursor condition to osteoporosis. ...


The International Society for Clinical Densitometry takes the position that a diagnosis of osteoporosis in men under 50 years of age should not be made on the basis of densitometric criteria alone. It also states that for pre-menopausal women, Z-scores (comparison with age group rather than peak bone mass) rather than T-scores should be used, and that the diagnosis of osteoporosis in such women also should not be made on the basis of densitometric criteria alone.[26]


Screening

The U.S. Preventive Services Task Force (USPSTF) recommended in 2002 that all women 65 years of age or older should be screened with bone densitometry.[27] The Task Force recommends screening only those women ages 60 to 64 years of age who are at increased risk. The best risk factor for indicating increased risk is lower body weight (weight < 70 kg), with less evidence for smoking or family history. There was insufficient evidence to make recommendations about the optimal intervals for repeated screening and the appropriate age to stop screening. Clinical prediction rules are available to guide selection of women ages 60-64 for screening. The Osteoporosis Risk Assessment Instrument (ORAI) may be the most sensitive strategy[28] Screening, in medicine, is a strategy used to identify disease in an unsuspecting population. ... A clinical prediction rule is type of medical research study in which researchers try to identify the best combination of medical sign, symptoms, and other findings in predicting the probability of a specific disease or outcome. ... The sensitivity of a binary classification test or algorithm, such as a blood test to determine if a person has a certain disease, or an automated system to detect faulty products in a factory, is a parameter that expresses something about the tests performance. ...


Regarding the screening of men, a cost-analysis study suggests that screening may be "cost-effective for men with a self-reported prior fracture beginning at age 65 years and for men 80 years and older with no prior fracture".[29]


Pathogenesis

The underlying mechanism in all cases of osteoporosis is an imbalance between bone resorption and bone formation. In normal bone, there is constant matrix remodeling of bone; up to 10% of all bone mass may be undergoing remodeling at any point in time. The process takes place in bone multicellular units (BMUs) as first described by Frost in 1963.[30] Bone is resorbed by osteoclast cells (which derive from the bone marrow), after which new bone is deposited by osteoblast cells. [5] Bone resorption is the process by which osteoclasts break down bone and release the minerals, resulting in a transfer of calcium from bone fluid to the blood. ... This article is about the skeletal organs. ... In biology, the word matrix is used for the material between animal or plant cells, or generally the material (or tissue) in which more specialized structures are embedded, and also specifically for one part of the mitochondrion. ... An osteoclast (from the Greek words for bone and broken) is a type of bone cell that removes bone tissue by removing the bones mineralized matrix. ... For the Dir en grey album, see The Marrow of a Bone. ... An osteoblast (from the Greek words for bone and germ or embryonic) is a mononucleate cell that is responsible for bone formation. ...


The three main mechanisms by which osteoporosis develops are an inadequate peak bone mass (the skeleton develops insufficient mass and strength during growth), excessive bone resorption and inadequate formation of new bone during remodeling. An interplay of these three mechanisms underlies the development of fragile bone tissue.[5] Hormonal factors strongly determine the rate of bone resorption; lack of estrogen (e.g. as a result of menopause) increases bone resorption as well as decreasing the deposition of new bone that normally takes place in weight-bearing bones. The amount of estrogen needed to suppress this process is lower than that normally needed to stimulate the uterus and breast gland. The α-form of the estrogen receptor appears to be the most important in regulating bone turnover.[5] In addition to estrogen, calcium metabolism plays a significant role in bone turnover, and deficiency of calcium and vitamin D leads to impaired bone deposition; in addition, the parathyroid glands react to low calcium levels by secreting parathyroid hormone (parathormone, PTH), which increases bone resorption to ensure sufficient calcium in the blood. The role of calcitonin, a hormone generated by the thyroid that increases bone deposition, is less clear and probably not as significant as that of PTH.[5] Estriol. ... This article is about female reproductive anatomy. ... Mammary glands are the organs that, in the female mammal, produce milk for the sustenance of the young. ... The estrogen receptor is a receptor for estradiol (the main endogenous estrogen); it is located intracellularly, in parallel with other steroid hormone receptors. ... Calcium Calcium metabolism or calcium homeostasis is the mechanism by which the body maintains adequate calcium levels. ... Calcium (Ca2+) plays a vital role in the anatomy, physiology and biochemistry of organisms and of the cell, particularly in signal transduction pathways. ... Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ... The four human parathyroid glands are adjacent to the thyroid. ... RNA expression pattern Orthologs Human Mouse Entrez Ensembl Uniprot na Refseq Location Pubmed search Parathyroid hormone (PTH), or parathormone, is secreted by the parathyroid glands as a polypeptide containing 84 amino acids. ... Calcitonin is a 32 amino acid polypeptide hormone that is produced in humans primarily by the parafollicular (also known as C) cells of the thyroid, and in many other animals in the ultimobranchial body. ...


The activation of osteoclasts is regulated by various molecular signals, of which RANKL (receptor activator for nuclear factor κB ligand) is one of best studied. This molecule is produced by osteoblasts and other cells (e.g. lymphocytes), and stimulates RANK (receptor activator of nuclear factor κB). Osteoprotegerin (OPG) binds RANKL before it has an opportunity to bind to RANK, and hence suppresses its ability to increase bone resorption. RANKL, RANK and OPG are closely related to tumor necrosis factor and its receptors. The role of the wnt signalling pathway is recognized but less well understood. Local production of eicosanoids and interleukins is thought to participate in the regulation of bone turnover, and excess or reduced production of these mediators may underlie the development of osteoporosis.[5] This article lacks information on the importance of the subject matter. ... NF-κB, or Nuclear Factor kappa B, is a nuclear transcription factor found in all cell types and is involved in cellular responses to stimuli such as stress, cytokines, free radicals, ultraviolet irradiation, and bacterial or viral antigens. ... A scanning electron microscope (SEM) image of a single human lymphocyte. ... Look up rank in Wiktionary, the free dictionary. ... In medicine, tumor necrosis factor alpha (TNFα, cachexin or cachectin) is an important cytokine involved in systemic inflammation and the acute phase response. ... The wnt signalling pathway is a network of proteins that has been implicated in embryogenesis and cancer. ... In biochemistry, eicosanoids are a class of oxygenated hydrophobic molecules that largely function as autocrine and paracrine mediators. ... Interleukins are a group of cytokines that were first seen to be expressed by white blood cells (leukocytes, hence the -leukin) as a means of communication (inter-). The name is sort of a relic though; it has since been found that interleukins are produced by a wide variety of bodily...


Trabecular bone is the sponge-like bone in the ends of long bones and vertebrae. Cortical bone is the hard outer shell of bones and the middle of long bones. Because osteoblasts and osteoclasts inhabit the surface of bones, trabecular bone is more active, more subject to bone turnover, to remodeling. Not only is bone density decreased, but the microarchitecture of bone is disrupted. The weaker spicules of trabecular bone break ("microcracks"), and are replaced by weaker bone. Common osteoporotic fracture sites, the wrist, the hip and the spine, have a relatively high trabecular bone to cortical bone ratio. These areas rely on trabecular bone for strength, and therefore the intense remodeling causes these areas to degenerate most when the remodeling is imbalanced.[citation needed] Trabecular bone (also known as spongy bone) is one of two main types of bone. ... Cortical bone, also known as compact bone is one of two main types of osseous tissues. ...


Treatment

There are several alternatives of medication to treat osteoporosis, though lifestyle changes are very frequently an aspect of treatment.


Medication

Bisphosphonates are the main pharmacological measures for treatment. However, newer drugs have appeared in the 1990s, such as teriparatide and strontium ranelate.

Bisphosphonates

In confirmed osteoporosis, bisphosphonate drugs are the first-line treatment. The most often prescribed bisphosphonates are presently sodium alendronate (Fosamax) 10 mg a day or 70 mg once a week, risedronate (Actonel) 5 mg a day or 35 mg once a week and or ibandronate (Boniva) once a month. In pharmacology, bisphosphonates (also called: diphosphonates) is a class of drugs that inhibits the resorption of bone. ... 2005 is a common year starting on Saturday of the Gregorian calendar. ... Alendronate (Fosamax) is a bisphosphonate drug used for the treatment of osteoporosis (see Maturitas 2004; 48: 179-192). ... Risedronate sodium (Actonel®) is a bisphosphonate used to strengthen bone and treat or prevent osteoporosis, and to treat Pagets disease of bone. ... Ibandronic acid (INN) or ibandronate sodium (USAN), marketed under the trade names Boniva®, Bondronat® and Bonviva®, is a potent bisphosphonate drug used in the prevention and treatment of osteoporosis. ...


A 2007 manufacturer-supported study suggested that in patients who had suffered a low-impact hip fracture, annual infusion of 5 mg zoledronic acid reduced risk of any fracture by 35% (from 13.9 to 8.6%), vertebral fracture risk from 3.8% to 1.7% and non-vertebral fracture risk from 10.7% to 7.6%. This study also found a mortality benefit: after 1.9 years, 9.6% of the study group (as opposed to 13.3% of the control group) had died of any cause, indicating a mortality benefit of 28%.[31] Zoledronate (INN: zoledronic acid, marketed by Novartis under the trade names Zometa® and Aclasta®) is a bisphosphonate. ...


Oral bisphosphonates are relatively poorly absorbed, and must therefore be taken on an empty stomach, with no food or drink to follow for the next 30 minutes. They are associated with esophagitis and are therefore sometimes poorly tolerated; weekly or monthly administration (depending on the preparation) decreases likelihood of esophagitis, and is now standard. Although intermittent dosing with the intravenous formulations such as zolendronate avoids oral tolerance problems, these agents are implicated at higher rates in a rare but unpleasant mouth disease called osteonecrosis of the jaw.[32] For this reason, oral bisphosphonate therapy is probably to be preferred, and prescribing advice now recommends any remedial dental work to be carried out prior to commencing treatment.[33] Esophagitis (or Oesophagitis) is inflammation of the esophagus. ... Osteonecrosis of the jaws (ONj) is a severe bone disease that affects the jaws, including the maxilla and the mandible. ...

Teriparatide

Recently, teriparatide (Forteo, recombinant parathyroid hormone residues 1–34) has been shown to be effective in osteoporosis. It acts like parathyroid hormone and stimulates osteoblasts, thus increasing their activity. It is used mostly for patients with established osteoporosis (who have already fractured), have particularly low BMD or several risk factors for fracture or cannot tolerate the oral bisphosphonates. It is given as a daily injection with the use of a pen-type injection device. Teriparatide is only licensed for treatment if bisphosphonates have failed or are contraindicated (however, this differs by country and is not required by the FDA in the USA. However, patients with previous radiation therapy, or Paget's disease, or young patients should avoid this medication). Teriparatide (Forsteo®) is a recombinant form of parathyroid hormone, used in the treatment of advanced osteoporosis. ... Recombinant proteins are proteins that are produced by different genetically modified organisms following insertion of the relevant DNA into their genome. ... RNA expression pattern Orthologs Human Mouse Entrez Ensembl Uniprot na Refseq Location Pubmed search Parathyroid hormone (PTH), or parathormone, is secreted by the parathyroid glands as a polypeptide containing 84 amino acids. ...

Strontium ranelate

Oral strontium ranelate is an alternative oral treatment, belonging to a class of drugs called "dual action bone agents" (DABAs) by its manufacturer. It has proven efficacy, especially in the prevention of vertebral fracture.[34] In laboratory experiments, strontium ranelate was noted to stimulate the proliferation of osteoblasts, as well as inhibiting the proliferation of osteoclasts. Strontium ranelate is a medication for osteoporosis marketed as Protelos or Protos by Servier. ...


Strontium ranelate is taken as a 2 g oral suspension daily, and is licenced for the treatment of osteoporosis to prevent vertebral and hip fracture. Strontium ranelate has side effect benefits over the bisphosphonates, as it does not cause any form of upper GI side effect, which is the most common cause for medication withdrawal in osteoporosis. In studies a small increase in the risk of venous thromboembolism was noted,[35] the cause for which has not been determined. This suggests it may be less suitable in patients at risk for thrombosis for different reasons. The uptake of (heavier) strontium in place of calcium into bone matrix results in a substantial and disproportionate increase in bone mineral density as measured on DXA scanning[36], making further followup of bone density by this method harder to interpret for strontium treated patients. A correction algorithm has been devised.[37] Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ...


Although strontium ranelate is effective, it's not approved for use in the United States yet. However, strontium citrate is available in the U.S. from several well-known vitamin manufacturers. Most researchers believe that strontium is safe and effective no matter what form it's used. The ranelate form is simply a device invented by the Servier company of France so that they could patent their version of strontium.[citation needed]


Strontium, no matter what the form, must be water-soluble and ionized in the stomach acid. Stontium is then protein-bound for transport from the intestinal tract into the blood stream. Unlike drugs like Fosamax, strontium doesn't inhibit bone recycling and, in fact, may produce stronger bones. Studies have shown that after five years alendronate may even cause bone loss, while strontium continues to build bone during lifetime use.[citation needed]


Strontium must not be taken with food or calcium-containing preparations as calcium competes with strontium during uptake. However, it's essential that calcium, magnesium, and vitamin D in theraputic ammounts must be taken daily, but not at the same time as strontium. Strontium should be taken on an empty stomach at night.[citation needed]


Nutrition

Calcium

Calcium is required to support bone growth, bone healing and maintain bone strength and is one aspect of treatment for osteoporosis. Recommendations for calcium intake vary depending country and age; for individuals at higher risk of osteoporosis (after fifty years of age) the amount recommended by US health agencies is 1,200 mg per day. Calcium supplements can be used to increase dietary intake, and absorption is optimized through taking in several small (500 mg or less) doses throughout the day.[38] The role of calcium in preventing and treating osteoporosis is unclear - some populations with extremely low calcium intake also have extremely low rates of bone fracture, and others with high rates of calcium intake through milk and milk products have higher rates of bone fracture. Other factors, such as protein, salt and vitamin D intake, exercise and exposure to sunlight, can all influence bone mineralization, making calcium intake one factor among many in the development of osteoporosis.[39] For other uses, see Calcium (disambiguation). ... Ossification is the process of bone formation, in which connective tissues, such as cartilage are turned to bone or bone-like tissue. ... X-ray of a bone fracture in the process of healing. ... For other uses of terms redirecting here, see US (disambiguation), USA (disambiguation), and United States (disambiguation) Motto In God We Trust(since 1956) (From Many, One; Latin, traditional) Anthem The Star-Spangled Banner Capital Washington, D.C. Largest city New York City National language English (de facto)1 Demonym American... A glass of cows milk. ...


A meta-analysis of randomized controlled trials involving calcium and calcium plus vitamin D supported the use of high levels of calcium (1,200 mg or more) and vitamin D (800 IU or more), though outcomes varied depending on which measure was used to assess bone health (rates of fracture versus rates of bone loss).[40] The meta-analysis, along with another study, also supported much better outcomes for patients with high compliance to the treatment protocol.[41] In contrast, despite earlier reports in improved high density lipoprotein (HDL, "good cholesterol") in calcium supplementation, a possible increase in the rate of myocardial infarction (heart attack) was found in a study in New Zealand in which 1471 women participated. If confirmed, this would indicate that calcium supplementation in women otherwise at low risk of fracture may cause more harm than good.[42] A meta-analysis is a statistical practice of combining the results of a number of studies. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicines or medical procedures. ... Compliance (or Adherence) in a medical context refers to a patient both agreeing to and then undergoing some part of their treatment program as advised by their doctor or other healthcare worker. ... High-density lipoproteins (HDL) form a class of lipoproteins, varying somewhat in their size (8–11 nm in diameter), that carry cholesterol from the bodys tissues to the liver. ... Heart attack redirects here. ...

Vitamin D

Some studies have shown that a high intake of vitamin D reduces fractures in the elderly,[40][43] though the Women's Health Initiative found that though calcium plus vitamin D did increase bone density, it did not affect hip fracture but did increase formation of kidney stones.[44] Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ... The Womens Health Initiative (WHI) was initiated by the National Institutes of Health (NIH) in 1991. ... “Bladder stone” redirects here. ...


Mechanical stimulation

Exercise

Multiple studies have shown that aerobics, weight bearing, and resistance exercises can all maintain or increase BMD in postmenopausal women.[45] Many researchers have attempted to pinpoint which types of exercise are most effective at improving BMD and other metrics of bone quality, however results have varied. One year of regular jumping exercises appears to increase the BMD and moment of inertia of the proximal tibia[46] in normal postmenopausal women. Treadmill walking, gymnastic training, stepping, jumping, endurance, and strength exercises all resulted in significant increases of L2-L4 BMD in osteopenic postmenopausal women.[47][48][49] Strength training elicited improvements specifically in distal radius and hip BMD.[50] Exercise combined with other pharmacological treatments such as hormone replacement therapy (HRT) has been shown to increases BMD more than HRT alone.[51] Moment of inertia, also called mass moment of inertia or the angular mass, (SI units kg m2, Former British units slug ft2), is the rotational analog of mass. ... This article is about the vertebrate bone. ... In zootomy, several terms are used to describe the location of organs and other structures in the body of bilateral animals. ... This article is about an authentication, authorization, and accounting protocol. ... Hormone replacement therapy (HRT) is a system of medical treatment for perimenopausal and postmenopausal women, based on the assumption that it may prevent discomfort and health problems caused by diminished circulating estrogen hormones. ...


Additional benefits for osteoporotic patients other than BMD increase include improvements in balance, gait, and a reduction in risk of falls.[52]

Low-level mechanical signals

Low-level high-frequency mechanical signals have been studied as signals stimulating bone turnover. Studies in animals show that this form of 'passive exercise' results in increased bone strength. Preliminary studies in humans (using for example vibrating platforms to produce whole body vibration) indicate that they might prevent BMD loss.[53] [54][55][56] Anabolism is the metabolic process that builds larger molecules from smaller ones. ... Vibrator advertisement, c. ...


Prognosis

Hip fractures per 1000 patient-years[57]
WHO category Age 50-64 Age > 64 Overall
Normal 5.3 9.4 6.6
Osteopenia 11.4 19.6 15.7
Osteoporosis 22.4 46.6 40.6

Although osteoporosis patients have an increased mortality rate due to the complications of fracture, most patients die with the disease rather than of it. Osteopenia is a decrease in bone mineral density that can be a precursor condition to osteoporosis. ...


Hip fractures can lead to decreased mobility and an additional risk of numerous complications (such as deep venous thrombosis and/or pulmonary embolism, pneumonia). The 6-month mortality rate following hip fracture is approximately 13.5%, and a substantial proportion (almost 13%) of people who have suffered a hip fracture need total assistance to mobilize after a hip fracture.[58] It has been suggested that Deep Vein Thrombosis be merged into this article or section. ... This article is about human pneumonia. ...


Vertebral fractures, while having a smaller impact on mortality, can lead to severe chronic pain of neurogenic origin, which can be hard to control, as well as deformity. Though rare, multiple vertebral fractures can lead to such severe hunch back (kyphosis) that the resulting pressure on internal organs can impair one's ability to breathe. Kyphosis (Greek - kyphos, a hump), in general terms, is a curvature of the upper spine. ...


Apart from risk of death and other complications, osteoporotic fractures are associated with a reduced health-related quality of life.[59] Quality of life is the degree of well-being felt by an individual or group of people. ...


Epidemiology

Lateral thoraco-lumbar spine X-ray demonstrating multiple wedge fractures
Lateral thoraco-lumbar spine X-ray demonstrating multiple wedge fractures

It is estimated[citation needed] that 1 in 3 women and 1 in 12 men over the age of 50 worldwide have osteoporosis. It is responsible for millions of fractures annually, mostly involving the lumbar vertebrae, hip, and wrist. Fragility fractures of ribs are also common in men. A diagram of a thoracic vertebra. ... Bones of the Hip In anatomy, the hip is the bony projection of the femur, known as the greater trochanter, and the overlying muscle and fat. ...


Hip fractures

Main article: hip fractures

Hip fractures are responsible for the most serious consequences of osteoporosis. In the United States, osteoporosis causes a predisposition to hip fractures -- more than 250,000 occur annually. It is estimated that a 50-year-old white woman has a 17.5% lifetime risk of fracture of the proximal femur. The incidence of hip fractures increases each decade from the sixth through the ninth for both women and men for all populations. The highest incidence is found among those men and women ages 80 or older.[citation needed] A hip fracture is a fracture in the proximal end of the femur (the long bone running through the thigh), near the hip joint. ... The femur or thigh bone is the longest, most voluminous, and strongest bone of the mammalian bodies. ...


Vertebral fractures

Between 35-50% of all women over 50 had at least one vertebral fracture. In the United States, 700,000 vertebral fractures occur annually, but only about a third are recognized. In a series of 9704 of women aged 68.8 on average studied for 15 years, 324 had already suffered a vertebral fracture at entry into the study; 18.2% developed a vertebral fracture, but that risk rose to 41.4% in women who had a previous vertebral fracture.[60]


Distal radius fractures

Distal radius fractures, usually of the Colles type, are the third most common type of osteoporotic fractures. In the United States, the total annual number of Colles' fractures is about 250,000. The lifetime risk of sustaining a Colles' fracture is about 16% for white women. By the time women reach age 70, about 20% have had at least one wrist fracture.[citation needed] The radius is the bone of the forearm that extends from the outside of your limb to your phlangx (lateral) of the elbow to the thumb side of the wrist. ... A Colles fracture is a fracture of the distal radius, most commonly caused by people falling forward onto a hard surface and breaking their fall with extended, outstretched hands - falling with wrists flexed would lead to a Smiths fracture. ...


Prevention

Methods to prevent osteoporosis include changes of lifestyle. However, there are medications that can be used for prevention as well. As a different concept there are osteoporosis ortheses which help to prevent spine fractions and support the building up of muscles. Fall prevention can help prevent osteoporosis complications.


Lifestyle

Lifestyle prevention of osteoporosis is in many aspects inversions from potentially modifiable risk factors. As tobacco smoking and unsafe alcohol intake have been linked with osteoporosis, smoking cessation and moderation of alcohol intake are commonly recommended in the prevention of osteoporosis.[citation needed] The cigarette is the most common method of smoking tobacco. ... Booze redirects here. ...

Exercise

Achieving a higher peak bone mass through exercise and proper nutrition during adolescence is important for the prevention of osteoporosis. Exercise and nutrition throughout the rest of the life delays bone degeneration. Jogging, walking, or stair climbing at 70-90% of maximum effort three times per week, along with 1,500 mg of calcium per day, increased bone density of the lumbar (lower) spine by 5% over 9 months. Individuals already diagnosed with osteopenia or osteoporosis should discuss their exercise program with their physician to avoid fractures.[61]

Nutrition

A proper nutrition is a diet sufficient in calcium and vitamin D. Patients at risk for osteoporosis (e.g. steroid use) are generally treated with vitamin D and calcium supplements and often with bisphosphonates. In renal disease, more active forms of Vitamin D such as paracalcitol or (1,25-dihydroxycholecalciferol or calcitriol which is the main biologically active form of vitamin D) is used, as the kidney cannot adequately generate calcitriol from calcidiol (25-hydroxycholecalciferol) which is the storage form of vitamin D. For other uses, see Calcium (disambiguation). ... Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ... This article is about the chemical family of steroids. ... Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ... The kidneys are the organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. ... Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ...


High dietary protein intake increases calcium excretion in urine and has been linked to increased risk of fractures in research studies.[62] Other investigations have shown that protein is required for calcium absorption, but that excessive protein consumption inhibits this process. No interventional trials have been performed on dietary protein in the prevention and treatment of osteoporosis.[63] Proteins are broken down in the stomach during digestion by enzymes known as proteases into smaller polypeptides to provide amino acids for the organism, including the essential amino acids that the organism cannot biosynthesize itself. ... This article is about the urine of animals generally. ...


Medication

Just as for treatment, bisphosphonate can be used in cases of very high risk. Other medicines prescribed for prevention of osteoporosis include raloxifene (Evista), a selective estrogen receptor modulator (SERM). In pharmacology, bisphosphonates (also called: diphosphonates) is a class of drugs that inhibits the resorption of bone. ... Raloxifene is an oral selective estrogen receptor modulator which is used in the prevention of osteoporosis in postmenopausal women. ... Selective estrogen receptor modulators (SERMs) is a class of medication that acts on the estrogen receptor. ...


Estrogen replacement therapy remains a good treatment for prevention of osteoporosis but, at this time, is not recommended unless there are other indications for its use as well. There is uncertainty and controversy about whether estrogen should be recommended in women in the first decade after the menopause. Hormone replacement therapy (HRT) is a system of medical treatment for surgically menopausal, perimenopausal and postmenopausal women, based on the assumption that it may prevent discomfort and health problems caused by diminished circulating estrogen and progesterone hormones. ...


In men, therapy with testosterone is controversial; in hypogonadal men it has been shown to give a (small) improvement in bone quantity and quality, but, as of 2008, there are no studies of the effects on fractures or in men with a normal testosterone level.[18] Testosterone is a steroid hormone from the androgen group. ...


History

The link between age-related reductions in bone density and fracture risk goes back at least to Astley Cooper, and the term "osteoporosis" and recognition of its pathological appearance is generally attributed to the French pathologist Jean Lobstein.[64] The American endocrinolgist Fuller Albright linked osteoporosis with the postmenopausal state.[65] Bisphosponates, which revolutionized the treatment of osteoporosis, were discovered in the 1960s.[66] Sir Astley P. Cooper Sir Astley Paston Cooper, 1st Baronet (August 23, 1768-February 12, 1841), English surgeon and anatomist, who made historical contributions to otology, vascular surgery, the anatomy and pathology of the mammary glands and testicles, and the pathology and surgery of hernia. ... Jean Georges Chrétien Frédéric Martin Lobstein (German spelling: Johann Friedrich Georg Christian Martin Lobstein) (May 8, 1777 - March 7, 1835) was a German-born, French pathologist and surgeon who was a native of Giessen. ... Fuller Albright (January 12, 1900 – December 8, 1969) was an American endocrinologist who made numerous contributions to his field, especially to the area of calcium metabolism. ...


See also

Back pain (also known dorsalgia) is pain felt in the back that may originate from the muscles, nerves, bones, joints or other structures in the spine. ... AHIP Protector Hip protectors are a quite new method for the prevention of hip fractures. ... An X-ray picture (radiograph), taken by Wilhelm Röntgen in 1896, of Albert von Kollikers hand X-rays (or Röntgen rays) are a form of electromagnetic radiation with a wavelength in the range of 10 to 0. ... Osteopetrosis is an extremely rare inherited disorder whereby the bones harden, becoming denser. ... Osteoimmunology (όστέον, osteon from Greek, “bone”; immunitas from Latin, “immunity”; and λόγος, logos, from Greek “knowledge”) is the study of the interface between the skeletal system and the immune system, comprising the “osteo-immune system”. It is also the study of shared components and mechanisms between the two systems in vertebrates, including...

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A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 151st day of the year (152nd in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 98th day of the year (99th in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 131st day of the year (132nd in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 260th day of the year (261st in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Otherwise known as the doctors prescribing Bible the British National Formulary (BNF) contains a wide spectrum of information on prescribing and pharmacology, among others indications, side effects and costs of the prescription of all medication drugs available on the National Health Service. ... // The British Medical Association (BMA) is the professional association and registered trade union for doctors in the United Kingdom. ... The Royal Pharmaceutical Society of Great Britain (RPSGB) is the regulatory and professional body for pharmacists in England, Scotland and Wales. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... NIAMS, the United States National Institute of Arthritis and Musculoskeletal and Skin Diseases, is a division of the National Institutes of Health. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... is the 305th day of the year (306th in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 28th day of the year in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... is the 28th day of the year in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

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Muscle weakness (or lack of strength) is a direct term for the inability to exert force with ones muscles to the degree that would be expected given the individuals general physical fitness. ... Rheumatism or Rheumatic disorder is a non-specific term for medical problems affecting the heart, bones, joints, kidney, skin and lung. ... Myalgia means muscle pain and is a symptom of many diseases and disorders. ... Neuralgia is a painful disorder of the nerves. ... Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ... Panniculitis is a group of diseases whose hallmark is inflammation of subcutaneous fatty and muscle tissue. ... Fibromyalgia (FM) is stated to be a disorder classified by the presence of chronic widespread pain and tactile allodynia. ... Bone disease refers to the medical conditions which affect the bone. ... Osteomalacia is a softening of the bones, resulting from defective bone mineralisation. ... Pseudarthrosis is the movement of a bone at the location of a fracture resulting from inadequate healing of the fracture. ... This article is about stress fractures in bones. ... Monostotic fibrous dysplasia (or monostotic osteitis fibrosa) is a form of fibrous dysplasia where only one bone is involved. ... Skeletal fluorosis is a bone disease exclusively caused by excessive consumption of fluoride. ... An aneurysmal bone cyst is an expansile osteolytic lesion with a thin wall, containing blood-filled cystic cavities. ... Hyperostosis is an excessive growth of bone. ... Osteomyelitis is an infection of bone, usually caused by pyogenic bacteria or mycobacteria. ... Avascular necrosis is a disease resulting from the temporary or permanent loss of the blood supply to the bones. ... Bold text X-ray of Pagets disease Pagets disease, otherwise known as osteitis deformans, is a chronic disorder that typically results in enlarged and deformed bones. ... Complex Regional Pain Syndrome (CRPS) is a chronic progressive disease characterized by severe pain, swelling and changes in the skin. ... Dissolution or degeneration of bone tissue through disease. ... In medicine, Chondropathy refers to a disease of the cartilage. ... Osteochondrosis is a orthopedic disease. ... Legg-Calvé-Perthes syndrome is a degenerative disease of the hip joint, where a loss of bone mass leads to some degree of collapse of the hip joint, that is, to deformity of the ball of the femur and the surface of the hip socket. ... Osgood-Schlatter disease (also known as tibial tubercle traumatic apophysitis) is an inflammation of the growth plate at the tibial tuberosity. ... Köhler disease (also spelled Kohler) is a rare bone disorder of the foot found in children between six and nine years of age. ... Severs disease, or calcaneal apophysitis, is the most frequent cause of heel pain in children between the ages of 8 and 13 and is due to an inflammation of growing plates, the calcaneus in the back of the foot due to the rapid growth of bone when compared to... Osteochondritis Dessicans is when a loose piece of bone and cartilage seperates from the end of the bone because of a loss of blood supply and insuffecient amounts of calcium. ... Tietzes syndrome, also known as costochondritis, is a benign inflammation of one or more of the costal cartilages. ... // Q00-Q99 - Congenital malformations, deformations and chromosomal abnormalities (Q00-Q07) Congenital malformations of the nervous system (Q00) Anencephaly and similar malformations (Q01) Encephalocele (Q02) Microcephaly (Q03) Congenital hydrocephalus (Q04) Other congenital malformations of brain (Q05) Spina bifida (Q06) Other congenital malformations of spinal cord (Q07) Other congenital malformations of nervous...

  Results from FactBites:
 
Osteoporosis Advice - Information on osteoporosis treatment, symptoms, exercises, prevention, and management of the ... (566 words)
Osteoporosis used to be a word that was only used by physicians, nowadays the term is well known and a wealth of information is available to the general public.
A more general definition is that osteoporosis symptoms are a systemic skeletal disease that is characterised by low bone mass and a deterioration of the micro-architecture of bone tissue that leads to bones becoming more fragile, increasing the probability of fractures.
Osteoporosis is generally considered as secondary to other conditions and there are three major classifications that are used when defining osteoporosis:
Osteoporosis - Symptoms, Treatment and Prevention (1487 words)
Osteoporosis is a disease of the bones characterized by a decrease in bone mass and structural deterioration of bone tissue, leading to bone fragility and increased susceptibility to fractures of the hip, spine and wrist.
Osteoporosis and low bone mass are common conditions, affecting as many as 44 million individuals in the United States.
Osteoporosis occurs when the resorption causes the bones to reach a fracture threshold (the point at which they are likely to break when subjected to a modest stress, such as falling).
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