Rheumatology Book

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OsteoporosisAka: Osteopenia

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  1. See Also
    1. Osteoporosis Secondary Causes
    2. Medication Causes of Osteoporosis
    3. Osteoporosis Evaluation
    4. Osteoporosis Management
  2. Epidemiology
    1. Prevalence: 28 Million in U.S. have Osteoporosis
    2. Women affected more often than men by ratio of 5:1
    3. Osteoporosis costs >$14 Billion per year (1997)
  3. Pathophysiology
    1. See Bone Physiology
    2. Osteoporosis mechanism
      1. Hypogonadism (Menopause or orchiectomy)
        1. Osteoclastic overactivity
      2. Age related loss: Osteoblast Underactivity
      3. Trabecular Bone turnover is much more rapid
        1. Osteoporosis first seen in spine and pelvis
        2. Trabecular Bone greater in spine and pelvis
  4. Risk Factors
    1. See Osteoporosis Risk Factors
  5. Course
    1. Peak bone mass occurs at 20-35 years
    2. Decline in bone mass starts after age 35-50 years
    3. Normal bone density loss is 1% per year
    4. Hypogonadism accelerates decline to 3-4% per year
      1. Menopause in women
      2. Orchiectomy in men (Prostate Cancer)
    5. Age 50 years
      1. Osteopenia in Men: 33-47%
      2. Osteoporosis in Men: 4-6%
    6. Age 65 years
      1. Men and women have similar rates of decline
    7. Age 75 years
      1. Dramatic increase in Incidence of Hip Fracture in men
    8. Age 80 years
      1. Women: 90% have osteoporosis (15% Hip Fracture risk)
      2. Men: 50% have Osteoporosis
    9. Age 90 years
      1. Women: Hip Fracture in 33%
      2. Men: Hip Fracture in 17%
  6. Types
    1. Type 1 Osteoporosis
      1. Postmenopausal women
      2. Trabecular Bone mass decreased
      3. Fracture sites
        1. Vertebral body (T7-T9)
        2. Distal forearm (Colles Fracture)
    2. Type 2 Osteoporosis
      1. Both sexes, Age over 60 years
      2. Both cortical and Trabecular Bone mass decreased
      3. Fracture sites
        1. Femoral neck (Most common)
        2. Proximal humerus
        3. Proximal Tibia
        4. Pelvis
  7. Complications: Fractures
    1. Total Fracture Incidence: 1.3 Million per year
    2. Hip Fracture Incidence: 250,000 per year
      1. See Hip Fracture for morbidity and mortality
    3. Vertebral Compression Fracture
      1. Occurs in 33% of women over age 50 years
  8. Evaluation
    1. See Osteoporosis Secondary Causes
    2. See Osteoporosis Evaluation
  9. Management
    1. See Osteoporosis Management
  10. Resources
    1. National Osteoporosis Foundation
      1. http://www.nof.org
      2. Phone: (800) 223-9994
    2. Physicians Guide to Prevention and Treatment of Osteoporosis
      1. http://www.nof.org/physguide/index.htm
  11. References
    1. Bilezikian (1999) J Clin Endocrinol Metab 84:3431
    2. Goddard (1998) Postgrad Med 104(4):54
    3. Heaney (1998) Endocrinol Metab Clin North Am 27:255
    4. Orwoll (1998) Endocrinol Metab Clin North Am 27:349
    5. South-Paul (2001) Am Fam Physician 63(5):897
    6. Taxel (1998) {a 6657} 53(8):22

Osteoporosis (C0029456)

Definition (MSH)Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis (OSTEOPOROSIS, POSTMENOPAUSAL) and age-related or senile osteoporosis.
Definition (CSP)loss of bone mass and strength due to nutritional, metabolic, or other factors, usually resulting in deformity or fracture; a major public health problem of the elderly, especially women.
Definition (NCI)(OSS-tee-oh-pa-ROW-sis) A condition that is characterized by a decrease in bone mass and density, causing bones to become fragile.
Definition (NCI)A condition of reduced bone mass, with decreased cortical thickness and a decrease in the number and size of the trabeculae of cancellous bone (but normal chemical composition), resulting in increased fracture incidence. Osteoporosis is classified as primary (Type 1, postmenopausal osteoporosis; Type 2, age-associated osteoporosis; and idiopathic, which can affect juveniles, premenopausal women, and middle-aged men) and secondary osteoporosis (which results from an identifiable cause of bone mass loss).
ConceptsDisease or Syndrome (T047)
ICD9733.0, 733.00
MSHD010024
BasqueOSTEOPOROSIA
DanishOsteoporose
DutchOsteoporosis
EnglishOP - Osteoporosis, Osteoporoses, Osteoporosis
FinnishLUUSTON HAURASTUMA/OSTEOPOROOSI
FrenchOsteoporose
GermanOsteoporose
Hungarianosteoporosis
ItalianOsteoporosi
NorwegianOSTEOPOROSE
PortugueseOsteoporose
SpanishOsteoporosis
SwedishOSTEOPOROS
Parent Conceptsosteopathy, chondropathy, acquired deformity (C0679391), Musculoskeletal and connective tissue disorders (C0263660), Bone Diseases, Metabolic (C0005944), Disorder of skeletal system (C0263661), Bone Disorders, General and NEC (C0549572), CALCIUM/PHOSPHATE ABNORMALITY (C0549633), Osteoporosis (C0029456), Other and unspecified bone or cartilage disorders (C0029586), Musculoskeletal (C0497254), Diagnosis/Diseases Component (C0497531), Non-Neoplastic Bone Disorder (C1334997), cancer-related problem/condition (C0280950), Bone Diseases (C0005940), Duplicate concept (C1274013)
SourcesAOD, CCS, COSTAR, CSP, CST, DXP, ICD9CM, ICPC, ICPCBAQ, ICPCDAN, ICPCDUT, ICPCFIN, ICPCFRE, ICPCGER, ICPCHUN, ICPCITA, ICPCNOR, ICPCPOR, ICPCSPA, ICPCSWE, LCH, LNC, MEDLINEPLUS, MSH, MTH, NCI, NDFRT, OMIM, PDQ, QMR, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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