Osteoporosis

Osteoporosis is characterized by reduced bone mass and deterioration of bone microarchitecture, leaving bones fragile and prone to fracture. It is mainly age-related, but is far more common in post-menopausal women because the decline in estrogen accelerates bone loss. Men can also develop osteoporosis, but due to fairly steady testosterone levels into old age and higher peak bone density, it is far less common in them.

Risk factors include smoking, heavy regular alcohol consumption, low body weight, menopause, Cushing’s syndrome and corticosteroid use, chronic inflammation of any cause, and treatment with cytotoxics or immunosuppressants.

Usually asymptomatic until a fracture occurs. Fractures of the wrist, spine, and hip are most common, and vertebral compression fractures may cause loss of height and a stooped posture.

• X-ray bone densitometry (DEXA scan) to measure bone mineral density
• Frequent or easily sustained fractures
• Post-menopausal status as a major risk factor
• Kyphosis from vertebral collapse
• Blood tests, including:
  • Full blood count
  • Electrolytes (calcium and phosphate)
  • Sex hormones (estrogen, progesterone, testosterone)
  • Renal and liver function
  • Vitamin D

Neck of femur fractures are very dangerous, and common in patients with osteoporosis.