Osteoporosis

Basics

Description

  • Overall decrease in bone mass
  • Skeletal fragility and increased risk of fracture
  • Trabecular bone (especially vertebrae and femur) is affected more commonly and earlier
  • Disease begins in adolescence, but fractures do not usually manifest until age ≥50
  • Females are affected more commonly than males, especially after menopause; thought to be related to estrogen deficiency or age; but males have greater morbidity and mortality receiving less fracture prevention treatments
  • Primary vs secondary types with primary age-related vs postmenopausal. Secondary typically related to medications or an underlying disease (<5% of all cases)

Etiology

  • 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

There's more to see -- the rest of this topic is available only to subscribers.