Osteoporosis

• What are some bedside investigations for osteoporosis?


  History

  Physical exam

  FRAX/screening tool -> assess 10 year fragility fracture risk
• Why is FRAX used for osteoporosis?


  Predict the absolute risk of hip fracture, and major osteoporotic fractures (spine, wrist, or shoulder) over 10 years
• What scan can be done for osteoporosis?


  DEXA of hip and lumbar spine
• What blood tests may be done for osteoporosis?

  FBC

  U&Es

  CRP

  ESR

  PTH

  Calcium

  Phosphate

  Vit D
• How is osteoporosis managed conservatively?


  Exercise

  Vit D and calcium

  Improve diet (inc vit D and calcium)
• How is osteoporosis managed pharmacologicaly?


  Oral bisphosphonates (alendronic acid)

  Dtrontium ranelate and raloxifene

  Denosumab
• What is osteoporosis?


  Progressive loss of bone mass

  Often asymptomatic
• What is the T score of someone with osteopaenia?

  -1.0 to -2.5 BELOW standard deviation of reference population
• What are some signs and symptoms of osteoporosis?


  Asymptomatic

  Height loss

  Stooped posture

  Fragility fractures
• What are some examples of areas related to fragility fractures?

  Hip

  Vertebrae

  Wrist
• What are some risk factors for osteoporosis?


  Age

  Female

  Low BMI

  Vit D deficiency

  Corticosteroid use

  Hyperparathyroidism
• What is the T score of someone with osteoporosis?


  More than 2.5 BELOW the standard deviation