Course Hero Logo

section7.pdf - CHAPTER 27—OSTEOPOROSIS AND OSTEOMALACIA...

Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. This preview shows page 1 - 2 out of 11 pages.

CHAPTER 27—OSTEOPOROSIS AND OSTEOMALACIADEFINITION OF OSTEOPOROSISTHE EPIDEMIOLOGY AND CONSEQUENCES OF OSTEOPOROSISREVIEW OF BONE REMODELINGBONE LOSSPATHOGENESIS OF OSTEOPOROSISDIAGNOSIS OF OSTEOPOROSIS AND PREDICTION OF FRACTUREPREVENTION AND TREATMENT OF OSTEOPOROSISWORKING WITH THE PATIENTMANAGEMENT OF VERTEBRAL FRACTURESOSTEOMALACIAANNOTATED REFERENCESOsteoporosis develops in older adults when the normal processes of bone formation and resorption becomeuncoupled or unbalanced, resulting in bone loss. Fractures are the result of decreased bone mass andstrength, and, in the case of wrist and hip fractures, they usually involve a fall. Osteoporosis prevention andtreatment programs should therefore focus on strategies that minimize bone resorption and maximize boneformation, as well as on strategies that reduce falls. Optimal treatment and prevention of osteoporosisrequire modification of risk factors, particularly smoking, physical activity, and diet, in addition topharmacologic intervention. Osteomalacia, a less common disorder, occurs when bone is inadequatelymineralized; the result is a syndrome of bone loss accompanied by bone pain, myopathy, fatigue, andfractures.DEFINITION OF OSTEOPOROSISOsteoporosis was defined previously by a consensus panel as a “disease characterized by low bone massand microarchitectural deterioration of bone tissue leading to enhanced bone fragility and a consequentincrease in fracture incidence.” According to this definition, the diagnosis of osteoporosis requires thepresence of a fracture. The World Health Organization now defines osteoporosis by bone mineral density(BMD) measurement, which allows diagnosis and treatment of osteoporosis prior to incident fracture. If awoman has BMD measurement at any site < 2.5 standard deviations below the young adult standard (a Tscore of <2.5), thediagnosis of osteoporosis can be made. Further, women with osteopenia (low bonemass, with a T score of2.5 but <1) and normal bone mass (with a T score of1) can also beidentified. Thus, the clinician can make the diagnosis of osteoporosis and begin the appropriate therapyprior to fracture in older adults. In addition, women with osteopenia can be placed on a preventive regimenand then followed carefully for further bone loss. Specific standards for definitions of osteoporosis have notbeen established for men or for racial and ethnic groups other than white persons, although it appears thatsimilar standards apply to men and to Hispanic women.THE EPIDEMIOLOGY AND CONSEQUENCES OF OSTEOPOROSISIn 1990 more than 1.25 million hip fractures were reported worldwide in women, and 500,000 in men. Inthe United States the estimated numbers of hip and vertebral fractures in women are more than 250,000 and500,000, respectively, per year. To this number must be added fragility fractures in men, which occur atabout one third the rate seen in women. Thus, approximately 1 million Americans suffer fragility fractures

Upload your study docs or become a

Course Hero member to access this document

Upload your study docs or become a

Course Hero member to access this document

End of preview. Want to read all 11 pages?

Upload your study docs or become a

Course Hero member to access this document

Term
Spring
Professor
nursing
Tags
postmenopausal osteoporosis

Newly uploaded documents

Show More

Newly uploaded documents

Show More

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture