Osteoporosis is characterized by bone fragility and low bone mass, resulting in an increased risk of fracture especially in the hip, wrist, humerus, rib, and pelvis.
Early diagnosis of osteoporosis is important to make the progression of the disease slower. Diagnosis of osteoporosis is based on bone mineral density (BMD) measurement by DXA of hips or spine bones. BMD testing is recommended for all males older than 70 years and in men 50 to 70 years when risk factors as radiographic osteopenia, history of low trauma fractures , and loss of more than 1.5 inches in height, long-term glucocorticoid therapy, androgen deprivation therapy for prostate cancer, hypogonadism, primary hyperparathyroidism, and intestinal disorders.
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condition
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T-score of DXA
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Normal bone mineral density
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T-score greater than or equal to -1 SD
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osteopenia
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T-score less than -1 and greater than -2.5 SD
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Osteoporosis
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T-score less than or equal to -2.5
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Severe osteoporosis
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T-score less than or equal to -2.5 with one or more fragility fractures.
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Symptoms:
Osteoporosis usually has no symptoms until there is a fracture. symptomatic vertebral fractures include pain and height loss.
Sometimes symptoms may be accompanied with other causing diseases hypogonadism, malabsorption, vitamin D deficiency, diabetes, and hyperparathyroidism.
Secondary osteoporosis:
always check if there a secondary cause of osteoporosis before initiating any pharmacotherapy, such as renal or liver disease, hyperparathyroidism, Cushing's syndrome, celiac disease and other forms of malabsorption, or idiopathic hypercalciuria or if patient is using any medication that decrease bone mineral density, such as (heparin, glucocorticoids, anti convulsant, chemotherapy, cyclosporine).
Glucocorticoid-induced osteoporosis:
the increased risk of fracture has been reported with doses of prednisolone or its equivalent as low as 2.5 to 7.5 mg daily.