Classical Features of OsteoporosisShama Rani Paul

Definition• Osteoporosis means ‘porous bones’ causes bones to become

weak and brittle, so brittle that even mild stresses causes fracture.• In most cases, bones weaken when low levels of calcium,

phosphorus, other minerals in the bones and results as low bone density.

• Common result of osteoporosis is fractures of spine, hip and wrist.• Although its thought as a women’s disease but it also affects men.• How to decide on bone loss? – If you are a postmenopausal

woman or Vitamin D deficient then don’t wait until you have symptoms to get screened. [ BONE MINERAL DENSITY (BMD) SCREENING - DEXA ]

• Colles fracture are particularly common in patients with osteoporosis and as such, they are most frequently seen in elderly women.

• The relationship between Colles fractures and osteoporosis is strong enough that when an older male patient presents with a Colles fracture, he should be investigated for osteoporosis because his risk of a hip fracture is also elevated.

Signs of OsteoporosisNOTE: The fact is, bone loss that leads to osteoporosis often occurs

without any noticeable symptoms, so by the time you have a fracture, feel pain, or develop curvature of the spine, osteoporosis may already be present. But if you identify bone loss early, you can take steps to reduce your risk of osteoporosis.

• Backache, which can be severe if fractured or collapsed vertebra• Loss of height overtime, with an accompanying stooped posture• Fracture of vertebra, wrist, hips or other bones• During post-menopausal period, every women must be aware of

osteoporosis and any fracture in that time must be evaluated to rule out osteoporosis.

Clinical Features• Clinical outcome of osteoporosis depends on which bone involved• Thoracic and lumbar fractures – extremely common, which

produce loss of height and various deformities (like kyphoscoliosis that can compromise respiratory function)

• Pulmonary embolism and pneumonia – common complications of fractures of femoral neck, pelvis, spine

• Colles' fracture is a common fracture in people with osteoporosis, second only to vertebral fractures.

• Asymptomatic post-menopausal osteoporosis is common but some-times associated with pain and deformity.

• Symptomatic osteoporosis is usually associated with fracture.(Kyphoscoliosis is a musculoskeletal disorder causing chronic

underventilation of the lungs and may be one of the major causes of pulmonary hypertension)

References• http://

www.everydayhealth.com/osteoporosis/early-signs-of-osteoporosis.aspx

• Robbins Pathology 8th Edition, page 806• http://radiopaedia.org/articles/colles-fracture• https://en.wikipedia.org/wiki/Colles'fracture• http://www.ncbi.nlm.nih.gov/pubmed/22081199

THANK YOU DR SOON AND GROUP MATES