Osteoporosis

Osteoporosis is a disease in which the bones lose calcium and become porous, weaker and susceptible to fractures. It is common in old age, particularly in women after menopause.

Causes

The most common cause of osteoporosis is menopause. With the hormonal changes of menopause, women become extremely susceptible to osteoporosis, and with time may develop serious bone and joint disorders.

Males in old age also develop osteoporosis.

Nutritional lack of vitamin D and calcium can cause osteoporosis. In children lack of vitamin D causes rickets rather than osteoporosis.

Disuse of a limb results in osteoporosis in that limb. Joint disease is also associated with osteoporosis of the bone near the joint.

Steroids can cause osteoporosis. Patients who have a tumor that produces steroids usually lose calcium from the bones, and develop osteoporosis. This can also occur as a side effect of steroid therapy.

Effects of osteoporosis

In osteoporosis, bones become particularly fragile. A fall or blow that would have no adverse effect on a normal person can result in a fracture in osteoporosis. Sudden lifting of a heavy weight can have the same result. Fractures at the spine, wrist, and hip are the most common, although any bone may break. Hip and spine fractures have a particularly grave significance. They cause the patient to become bedridden, with disastrous results at that age.

Fractured bones take longer to heal.

Diagnosis

Osteoporosis is diagnosed by X-rays. The lack of bone density is obvious on a plain X-ray of the bone. Very early osteoporosis can be diagnosed by bone densitometry.

Treatment

Osteoporosis is managed by treating the cause. Nutritional osteoporosis is treated with suitable doses of calcium (usually over 1G per day) and vitamin D. Patients with joint disorders, and those recovering from fractures and bone operations should be on a closely monitored exercise and physiotherapy regime. This is also the treatment for osteoporosis in elderly men and women.

Women below 55 should be considered for hormone replacement therapy.

Fractures are treated in the usual way. In the elderly, fractures are treated more aggressively with implants, so that prolonged bed rest is not required.