Osteoporosis - An Aging Issue

Osteoporosis is defined as a diffuse reduction in bone density due to decrease in bone mass. Decreased density in osteoporosis is due to deficiency of protein matrix in which calcium is laid down. It is the most common skeletal disorder in the world .It is often referred to as ‘Silent Killer’ bone loss occurs without symptom initially. Patient often present with fracture when it is diagnosed. About 1.5 million fractures occur annually worldwide due to osteoporosis.In India 1 out of 3 females suffer from osteoporosis. About 50 million patients are suffering from osteoporosis in India (By 2015). By 2050 1 out of 2 hip fractures would occur in India.

Causes Of Osteoporosis-

• Senile osteoporosis- Age related- Most common.
• Post Menopausal
• Smoking
• Endocrine disorder- Hypogonadal state, Thyrotoxicosis, Hyperparathyroidism, Cushing syndrome
• Rheumatoid Arthritis, Ankylosing Spondylitis
• Drug induced- Steroid, Heparin, etc.
• Post Hysterectomy

Clinical feature

Osteoporosis itself has no symptoms; its main consequence is the increased risk of bone fractures.  Early symptom may be acute pain which increases by sitting, sneezing coughing and relieved by rest. Typical fragility fractures occur in the vertebral column, rib, hip and wrist.

Investigations

• Radiology- Sign may not appear early in radiograph . 30% bone loss must before apparent on xray. Findings include loss of vertebral height,codfish spine and even fractures.
• DEXA Scan- Gold standard in quantification of bone mass.

Management

The general measures that are to be taken are:

• High protein and calcium rich diet.
• Rest
• Orthosis like spinal braces
• Exercises like walking and postural exercises

The good news is there are many steps that can be taken to prevent and diagnosis osteoporosis. It’s now a largely treatable condition and, with a combination of lifestyle modification  and appropriate medical treatment, many fractures can be avoided.