OSTEOPOROSIS An update. May 2012. Osteoporosis. Df : A progressive systemic skeletal disorder characterised by a low bone mass and micro-architectural deterioration of bone. T score of < -2.5 when measuring bone mineral density on DEXA scan (Dual –energy x-ray absorptiometry)
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However remodelling can become imbalanced so result in significant bone loss
If ≥ 75 yrs + DEXA clinically inappropriate clincial assessment is sufficient for diagnosis. 3
Stop smoking. Pre-menopause leads to 25 % ↓# rate postmenopausal 4
1. osteoporosis, no # 2. osteoporosis, already sustained #
1st line Alendronate
2nd line Risedronate and Etidronate
3rd line Strontium Ranelate
4th line Denosumab
1st line alendronate
2nd line risedronate/etidronate
3rd line strontium ranelate/raloxifene
4th line teriparatide
If there are contraindications, intolerances or side effects then the next line of treatment should be tried.
1. Parental history of hip #
2. Alcohol intake ≥ 4 units per day
SIGN (Scottish intercollegiate guidelines network) guidelines for osteoporosis.
http://www.sign.ac.uk/guidelines updated 2004.