Osteoporosis is a disease of bone in which the amount of bone is decreased and the strength of trabecular bone is reduced, cortical bone becomes thin and bones are susceptible to fracture. It is defined according to the bone mineral density (BMD) as measured by DEXA: a BMD of 2.5 standard deviations below the peak bone mass (20 year old person standard) is considered osteoporosis. While treatment modalities are becoming available, prevention is still the most important way to reduce fracture.
Osteoporotic fractures are those that occur in situations that would not lead to fractures in nonosteoporotic people. Typical fractures are vertebral fractures, hip fractures and those of the distal forearm. Collapse of vertebrae leads to chronic pain and characteristic bent statue, while the fractures of the long bones acutely impair mobility and may require surgery. Hip fracture, in particular, carries a poor prognosis.
While osteoporosis may occur in men, the problem is overwhelmingly one of postmenopausal women.
Risk factors for osteoporotic fracture can be split between modifiable and non-modifiable:
*Nonmodifiable: history of fracture as an adult, family history of fracture, female sex, advanced age, Caucasian race, dementia
*Potentially modifiable: tobacco smoking, intake of soft drinks (containing phosphoric acid), low body weight <58 kg (127 lb), estrogen deficiency, early menopause (<45 years) or bilateral oophorectomy, prolonged premenstrual amenorrhea (>1 year), low calcium intake, alcoholism, impaired eyesight despite adequate correction, recurrent falls, inadequate physical activity (i.e. too less but also far too excessive), poor health/frailty
Common Musculoskeletal Disorders
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