Decreased bone density caused by osteoporosis eventually leads to a increased fracture risk.
Bone density is constantly changing in the course of a lifetime. While initially increasing bone mass in childhood, adolescence and early adulthood growing human, a maximum is reached to the thirtieth year of life around. This is called "peak bone mass". These peaks are men on average higher than in women. In both sexes, it comes in the course of the additional years of life to a continuous decline in bone mass, which is referred to as bone loss and osteoporosis.
The loss of bone mass is based on a mismatch between bone formation by osteoblasts and bone resorption by osteoclasts. By the osteoclasts, it mined more bone mass than can be newly formed by osteoblasts. The relative activity of osteoclasts and osteoblasts is determined by paracrine factors.
epidemiology
Osteoporosis is a disease that manifests itself typically -for women after the 45th respectively and in men over 55 years of age. Women are affected twice as often as men. The information on the prevalence and incidence are wavering. The prevalence is specified for Germany between 4 and 8% of the total population
A distinction between primary and secondary osteoporosis. The following classification goes back to rings.
Primary osteoporosis: occurrence without identifiable causes, mostly in the higher age
Juvenile osteoporosis
Postmenopausal osteoporosis
Senile osteoporosis
Secondary osteoporosis: concomitant disease in other diseases
Endocrine causes: errors in hormonal balance with consequences for the bone system
Cushing's disease
Hypogonadism
Hyperthyroidism
Hyperparathyroidism
Acromegaly
Metabolic causes: errors in bone metabolism
Homocystinuria
Diabetes mellitus
Drug causes: side effects on the bone system (the following list is incomplete, and to name only a few examples)
Tamoxifen
Heparin
Absorption-inhibiting medications (laxatives, organic)
Oncological causes: tumours of the bone system
Plasmacytoma
Immunological causes: errors of bone Homeostasis by immune reactions
Chronic Polyarthritis
Crohn's disease (rare)
Mechanical causes: regression of bone stability due to lack of loading (inactivity osteoporosis)
Immobilization
Paralysis
Other causes
CRPS
Special types of osteoporosis:
Osteoporosis circumscripta cranii
Renal Osteodystrophy
Osteoporosis congenita
In
addition to direct causes of osteoporosis, a variety of risk factors
can be made among which in addition to a higher age also smoking or sex.
5 symptoms
Osteoporosis is initially totally asymptomatic and is noticeable only in advanced stages of the disease. The symptoms of advanced osteoporosis include:
Fractures (femoral, wrist and vertebral bodies)
Back pain and hunched back
Size loss
The diagnosis of osteoporosis includes the exclusion diagnosis of other diseases affect bone metabolism in the first place. The detection of the disease using x-rays or Osteodensitometry. In the X-ray, the bone structure because of the increased transparency of the rays is lightened. A thinning of the cancellous bone in the direction of the main load is typical.
Quantitative ultrasound or computed tomography measurements to determine bone density.
In rare cases, the removal of bone material in the context of a biopsy is indicated.
7 therapy
The treatment is dependent on the degree of osteoporosis and includes a number of medications
Calcium
Fluoride
Vitamin D
Bisphosphonates
Estrogens and progestins
Calcitonin
Anabolic steroids
In addition, patients benefit from adequate pain treatment and physiotherapeutic measures. In rare cases a surgical stabilization of the skeletal system must be carried out.
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