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Manual 100 questions & answers about osteoporosis and osteopenia

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Talk to your doctor before taking a calcium supplement. Vitamin D helps your body absorb calcium. The recommendation for Vitamin D is IU international units daily. Supplemented dairy products are an excellent source of Vitamin D. A cup of milk contains IU of Vitamin D. A multivitamin contains IU of Vitamin D. Vitamin supplements can be taken if your diet does not contain enough of this nutrient. Again, consult with your doctor before taking a vitamin supplement.

Too much Vitamin D can be toxic. Like muscles, bones need exercise to stay strong. No matter what your age, exercise can help minimize bone loss while providing many additional health benefits.


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Doctors believe that a program of moderate, regular exercise 3 to 4 times a week is effective for the prevention and management of osteoporosis. Weight-bearing exercises such as walking, jogging, hiking, climbing stairs, dancing, treadmill exercises, and weight lifting are probably best. Programs that emphasize balance training, especially tai chi, should be emphasized.

Consult with your doctor before beginning any exercise program. The diagnosis of osteoporosis is usually made by your doctor using a combination of a complete medical history and physical examination, skeletal x-rays, bone densitometry, and specialized laboratory tests. If your doctor diagnoses low bone mass, he or she may want to perform additional tests to rule out the possibility of other diseases that can cause bone loss, including osteomalacia a metabolic bone disease characterized by abnormal mineralization of bone or hyperparathyroidism overactivity of the parathyroid glands.

Loss of height and a stooped appearance of a person with osteoporosis results from partial collapse of weakened vertebrae. Bone densitometry is a safe, painless x-ray technique that compares your bone density to the peak bone density that someone of your same sex and ethnicity should have reached at 20 to 25 years of age.

Bone densitometry is often performed in women at the time of menopause. Several types of bone densitometry are used today to detect bone loss in different areas of the body.


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  7. Dual-energy x-ray absorptiometry DEXA is one of the most accurate methods, but other techniques can also identify osteoporosis, including single photon absorptiometry SPA , quantitative computed tomography QCT , radiographic absorptiometry, and ultrasound. Your doctor can determine which method is best suited for you.

    Because lost bone cannot be replaced, treatment for osteoporosis focuses on the prevention of further bone loss. Treatment is often a team effort involving a physician or internist, an orthopaedist, a gynecologist, and an endocrinologist.


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    Although exercise and nutrition therapy are often key components of a treatment plan for osteoporosis, there are other treatments as well. Estrogen replacement therapy ERT is often recommended for women at high risk for osteoporosis to prevent bone loss and reduce fracture risk. A measurement of bone density when menopause begins may help you decide whether ERT is right for you.

    Hormones also prevent heart disease, improve cognitive functioning, and improve urinary function. ERT is not without some risk, including enhanced risk of breast cancer; the risks and benefits of ERT should be discussed with your doctor. New anti-estrogens known as SERMs selective estrogen receptor modulators can increase bone mass, decrease the risk of spine fractures, and lower the risk of breast cancer. Calcitonin is another medication used to decrease bone loss. A nasal spray form of this medication increases bone mass, limits spine fractures, and may offer some pain relief.

    Bisphosphonates, including alendronate, markedly increase bone mass and prevent both spine and hip fractures.

    ERT, SERMs, calcitonin, and bisphosphonates all offer patient with osteoporosis an opportunity to not only increase bone mass, but also to significantly reduce fracture risk. Prevention is preferable to waiting until treatment is necessary. Your orthopaedist is a medical doctor with extensive training in the diagnosis and nonsurgical and surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves. This has been prepared by the American Academy of Orthopaedic Surgeons and is intended to contain current information on the subject from recognized authorities.

    However, it does not represent official policy of the Academy and its text should not be construed as excluding other acceptable viewpoints. Basics Handouts. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.

    Osteoporosis and Spinal Fractures. Transient hypercalcemia , dizziness, nausea, headache. Contraindicated in Paget's disease due to potential osteosarcoma risk. Average 4. Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine. Just skip this one for now. She denies any trauma or prior history of hip pain.

    Class Professional | Questions & Answers About Osteoporosis And Osteopenia

    Her past medical history is reviewed including a list of her current medications. Which of the following of her medications would place her at increased risk for a non-traumatic hip fracture? Review Topic. Which of the following lab values is most likely to be abnormal in this patient? In regards to bone health and osteoporosis prevention, what dose of calcium and vitamin D should be recommended for daily consumption?

    Review of her medical history reveals that she carries a diagnosis of osteoporosis, and that her latest T-score was How much calcium should she have been consuming on a daily basis prior to sustaining her injury? Following surgical treatment of the fracture, which of the following is the most appropriate additional investigation?

    A hospitalist consult was obtained for medical clearance pre-operatively, and she was diagnosed with osteoporosis. Which of the following treatment scenarios will lead to the best management of the patient's osteoporosis? Schedule a follow-up appointment with the patients primary care physician to initiate therapy. Have the patient meet with a nutritionist to increase her calcium and vitamin D intake.

    Osteopenia: The Warning Sign

    Start bisphosphonates, and have the patient follow-up with her primary care physician. Perform a metabolic work-up as an inpatient, and set-up an appointment in an osteoporosis clinic. Which of the following treatments is indicated in this patient? She is an avid tennis player, and history reveals no previous fractures. What is the most appropriate follow-up care?

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    She complains of deformity and wrist pain. Radiographs are provided in Figure A. Following closed reduction, the patient inquires whether she has osteoporosis and if she is likely to have another fracture. In counselling the patient, which of the following is the strongest predictor for a future fracture from low energy trauma?

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    Upgrade to PEAK. Take This Question Anyway. Review Topic QID: Orthobullets was not involved into the editorial process, and does not have the ability to alter. QID: One cannot make this diagnosis without further information. Essential Core Tested Community All. Sort by. Login to View Community Videos. Susan Bukata. What's New in Osteoporosis? Please login to add comment.

    Cancel Save. Definition main characteristics common to both osteopenia and osteoporosis age-related decrease in bone mass secondary to uncoupling of osteoclast-osteoblast activity disrupted microarchitecture WHO definition see table below Epidemiology incidence 10 million Americans and million people worldwide have osteoporosis 34 million Americans have osteopenia 1. Type I Post menopausal.