Osteoporosis: Anatomy and Physiology
Osteoporosis
Anatomy & Physiology 250
CASE - Module 2
Osteoporosis is a condition of low bone density that can progress silently over a long period of time. Osteoporosis has no symptoms until a fracture occurs, which causes bone pain, height loss, and abnormal spine curvature. If a fracture is determined to be due to osteoporosis, it is considered a pathological fracture, which is a break of a diseased or weakened bone without any identifiable trauma or following a minor injury that would not ordinarily break a healthy bone (Manolagas).
If diagnosed early, the fractures associated with the disease can often be prevented. Unfortunately, Osteoporosis frequently remains undiagnosed until a fracture occurs.
In order for a clinician to confirm a diagnosis of Osteoporosis, there needs to be an assessment of the history of the patient. The history of possible fragility fractures are the most reliable predictor of the risk of future fractures, and can be used to make a diagnosis of Osteoporosis. If the patient’s bone loss is acute, it is more likely to result in perforation of trabecular structures and fragility that is out of proportion to the bone density.
The patient is treated for osteoporosis with a bisphosphonate. The patient’s bone density will increase over the years. A diagnosis of osteoporosis can be made in the presence of a fragility fracture despite the presence of normal BMD in this instance.
However, as we age, an alteration in normal bone structure and function will lead to a gradual restructuring of the bones. Resorption of the minerals on the inside of the cortical layer and in the bone cavity itself leads to loss of trabecular bone and a widening of the bone cavity. This is partly compensated for by the gradual addition of extra layers of mineral to the outside of the cortical layer (iofbonehealth).
Bone mass peaks at age 25 years and women lose bone mass rapidly in the first 4 to 8 years following menopause, making them more
Anatomy & Physiology 250
CASE - Module 2
Osteoporosis is a condition of low bone density that can progress silently over a long period of time. Osteoporosis has no symptoms until a fracture occurs, which causes bone pain, height loss, and abnormal spine curvature. If a fracture is determined to be due to osteoporosis, it is considered a pathological fracture, which is a break of a diseased or weakened bone without any identifiable trauma or following a minor injury that would not ordinarily break a healthy bone (Manolagas).
If diagnosed early, the fractures associated with the disease can often be prevented. Unfortunately, Osteoporosis frequently remains undiagnosed until a fracture occurs.
In order for a clinician to confirm a diagnosis of Osteoporosis, there needs to be an assessment of the history of the patient. The history of possible fragility fractures are the most reliable predictor of the risk of future fractures, and can be used to make a diagnosis of Osteoporosis. If the patient’s bone loss is acute, it is more likely to result in perforation of trabecular structures and fragility that is out of proportion to the bone density.
The patient is treated for osteoporosis with a bisphosphonate. The patient’s bone density will increase over the years. A diagnosis of osteoporosis can be made in the presence of a fragility fracture despite the presence of normal BMD in this instance.
However, as we age, an alteration in normal bone structure and function will lead to a gradual restructuring of the bones. Resorption of the minerals on the inside of the cortical layer and in the bone cavity itself leads to loss of trabecular bone and a widening of the bone cavity. This is partly compensated for by the gradual addition of extra layers of mineral to the outside of the cortical layer (iofbonehealth).
Bone mass peaks at age 25 years and women lose bone mass rapidly in the first 4 to 8 years following menopause, making them more
References: Ettinger B, Pressman A, Sklarin P, Bauer D, Cualey JA, and Cummings, SR. (1998) Bone Density and Fractures among Elderly Women: SOF. J Clin Endocrinol Metab; Jacobs-Kosmin, D. Osteoporosis - http://emedicine.medscape.com/article/330598-overview#a0104 Manolagas SC, Jilka RL. (1995) Emerging Insights into the Pathophysiology of Osteoporosis. New England Journal of Medicine, http://www.osteoporosisguide.org/Pathophysiology_of_Osteoporosis.htm Seeman E. (1997)From density to structure: Growing Up and Growing Old on the Surfaces of Bone. J Bone Min Res. Shiel, W., e medicine health; Retrieved from website on Dec 13, 2011; http://www.emedicinehealth.com/osteoporosis/article_em.html http:/www.iofbonehealth.org/health-professionals