difference bw osteoperosis and osteomalacia
osteoperosis-normal bone just less of it
Osteomalacia- abnormal bone
3 presentations of osteoporosis
- Generalized (primary or secondary
- Regional (disuse, CRPS, transient)
- Localized (secondary)
What age is associated w generalized osteoperosis
- After age 35
- Post enopausal women 50-65
What age is peak bone mass
30
ratio of women and men who have osteoporosis
1 in 4 women
1 in 8 men
Primary conditions that cause osteoperosis in younger indvs
- Osteogenesis Imperfecta
- Marfans syndrome
Plain film signs of osteoperosis (5)
- increased radioluceny of bone
- Thin cortices (<1/2 of mid shaft diameter)
- Accentuation of weight bearing trabeculae
- possible compression fxs
- Reinforcement lines (in severe forms)
New compression fx findings (3)
- zone of sclerosis
- step defect
- ant wedging
Common cause of compression fxs @ T5 and above
Grand mal seizures
What is the look of codfish vertebrea and cause
- Sig lucency in vert body
- vert lines in vert body (multiple lvls)
–generalized osteoperosis
Secondary causes associated with osteoperosis
- malignancy
- steroid induced
- cushings disease
- diabetes
- hyperthyroidism, parathyroidism
- thalassemia major
What is wards triangle and what will happen
lucent area in femoral neck bw trabeluclations
-will increase in size as osteoporosis develops
What is the least sensitive and gold standard for bone density imaging
radiography- least sensitive (useful initially tho)
Bone density- DEXA gold standard
What is the T and Z score
T- persons bone density compared to the average
Z- persons bone density compared to an individual of the same age/gender
What are the sig T scores
o- -1= normal
-1- -2.5= osteopenia
below -2.5= osteoperosis
tx of osteoperosis
Calcium and vit D
Resistence/weight bearing exercises
meds: bisphosphonates, calcitonin, parathyroid hormone
Surg: vertebroplasty
