Osteoporosis

Basics

Overall decrease in skeletal mass, generally diffuse
Skeletal fragility and increased risk of fracture
Trabecular bone (especially vertebrae and femur) affected more commonly and earlier
Disease begins in adolescence, but fractures do not usually manifest until age ≥50
Females affected much more commonly than males, especially after menopause; thought related to estrogen deficiency or age

Overall increase in resorption over formation of new bone
Advanced age is the most important risk factor
Inadequate dietary calcium an important factor, especially early in life
Sedentary lifestyle is a risk factor (weight bearing on bone favors new bone formation)
Decrease in estrogen with menopause key factor in women
Other risk factors include long-term steroid use, alcoholism, methotrexate, tobacco use, low body weight
Familial or hereditary factor may coexist

Pediatric Considerations
Although disease appears to start in adolescence, pediatric patients are asymptomatic

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