OSTEOPOROSIS Winda Setyowulan Trisakti University Bekasi City General Hospital 2014
osteoporosis.pptx
Jan 20, 2016
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OSTEOPOROSIS
Winda SetyowulanTrisakti University
Bekasi City General Hospital2014
04/21/2023 [email protected] 2
TOPICS
• Defining Osteoporosis• Material and Structural Basis of Skeletal Fragility• Skeletal Heterogeneity• The Purposes of Bone Remodeling• Definition of Osteoporosis• Diagnosis• Pathogenesis• Prevention• Treatment
04/21/2023 [email protected] 3
Defining Osteoporosis
Osetoporosis: a condition of generalized skeletal fragility in which bone strength is sufficiently weak that fractures occur with minimal trauma
Riggs
• A loss of trabecular bone after menopause
• Lack of endogenous estrogenType I• A loss of cortical and trabecular bone
in men and women due to age-related• Long-term remodeling inefficiency,Type II
04/21/2023 [email protected] 4
Material and Structural Basis of Skeletal Fragility
WHOLE BONE STRENGTH
BONE SIZEmass
BONE MORPHOLOGYshape (distribution of bone
mass)microarchitecture
PROPERTIES OF BONE MATERIALdensitymatrix
collagen traitsmicrodamage
BONE REMODELINGBalance of formation / resorption
04/21/2023 [email protected] 5
Skeletal HeterogeneityFeature Central Peripheral
Main bone tissue Cancellous Cortical
Main soft tissue Viscera Muscle
Main joint type Various Synovial
Cortices Thin Thick
Marrow Hematopoietic Fatty
Turnover High Low
Feature Red Marow Yellow Marrow
Bone type Cancellous Cortical
Location Viscera Muscle
Main functions Various Synovial
Cancellous Bone
04/21/2023 [email protected] 6
The Purposes of Bone Remodeling
• Maintain its ability to carry out its function
mechanical
calcium homeostasis
hematopoiesis
04/21/2023 [email protected] 7
Definition of Osteoporosis
“a disease characterized by low bone mass and microarchitectural deterioration of bone tissue
leading to enhanced bone fragility and a consequent increase in fracture risk”
Consensus Development Conference, 1991
04/21/2023 [email protected] 8
Diagnosis
Useful in diagnosis, prognosis, and selection cases for treatment
Calculate the bone mineral density (BMD)!
04/21/2023 [email protected] 10
Prevention
• 1500 mg dailyCalcium supplement
• Norethindrone 5 mg daily
Hormon therapy
• With calciumVitamin D
04/21/2023 [email protected] 11
Treatment
If the fasting urine calcium and bone markers are high but the urine sodium is normal, treatment can take any form that inhibits bone resorption such as calcium and/or estrogen or norenthindrone
• If the urine Na/Cr is over 15, then salt intake is high, and simple salt restriction may be sufficient to bring down bone turnover
If radiocalcium absorption is low, it usually responds to calcitriol 0.25 mg daily unless due to an intrinsic bowel disorder such as celiac disease. It is perfectly safe to give 500-1000 mg of calcium as well and little point in giving calcitriol without calcium
• Low calcium absorption in postmenopausal women will also generally respond to estrogen or norethindrone
