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For the Patient Case for this case study,see the printed book.DISEASE SUMMARYDefinitionsOsteoporosis has been defined in both qualitative and quantitative terms. The term metabolicbone disease denotes those conditions characterized by decreased bone density or mass (i.e.,osteopenia) and diminished bone strength. Osteoporosisis a common, chronic, progressivetype of metabolic bone disease of multifactorial etiology in which bone tissue is normallymineralized but the density of bone is decreased, causing bones to become thin and brittleand making them more likely to break. The pathology of osteoporosis is illustrated in DiseaseSummary Figure 79.1. The disease can be generalized, involving major portions of the skele-ton, or regional, involving only one segment. Although osteoporosis-related fractures canoccur in any skeletal bone region, the spine, hips, and wrists are the most common sites asillustrated in Disease Summary Figure 79.2. Bones affected by osteoporosis can fracture withonly minor injury that normally would not cause a bone fracture. Even routine activities,such as bending over or coughing, can result in a fracture. Fractures can result from crack-ing (as with a hip fracture) or collapsing (as with a compression fracture of the vertebrae).Osteoporosis is a “silent disease” because there are few symptoms in the early stages of thedisease and the condition generally comes to attention only after a bone has been broken.The World Health Organization (WHO) has defined osteoporosis in quantitative termsbased on bone density. Whereas normal bone density is 833 mg/cm2, osteopenia occurswhen bone density is 648–833 mg/cm2and osteoporosis is present when bone density is648 mg/cm2.In more clinical terms, osteoporosis has developed when bone mineral densityT-scores established by dual-energy x-ray absorptiometry (DEXA or DXA) are less than –2.5.Although this bone disease typically becomes symptomatic in the middle and later yearsof life, susceptibility to osteoporosis begins early in life. Because peak bone density isreached at approximately 25 years of age, it is important to build strong bones by the thirddecade of life so that bones will remain strong later in life. Adequate calcium intake is anessential part of building strong bones.PrevalenceAccording to the International Osteoporosis Foundation, osteoporosis affects approximatelyone in three women and one in eight men worldwide. Currently, an estimated 24–28 millionAmericans have abnormally low bone mass. Eighty percent of all patients with osteoporo-sis are women.C A S E S T U D YOSTEOPOROSIS79DS79-1Case Study 79 Osteoporosis
DS79-2Case Study 79 OsteoporosisBecause bones become weaker with aging, those individuals older than age 50 years areat greatest risk for developing osteoporosis. An estimated 10 million Americans older than age50 have osteoporosis and another 34 million are osteopenic and considered high risk fordeveloping the disease. This amounts to 55% of the U.S. population 50 years of age and older.

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Term
Summer
Professor
RECKTENWALD
Tags
Bone fracture

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