Osteoporosis

• Facts:
  Decreased bone mass and increased bone fragility
  T-score -1.5 to -2.5 (osteopenia)
  T-score < -2.5 (osteoporosis)
• Diagnosis:
  DEXA scan (gold standard)
  Increased bone turnover (increased urinary N-telopeptides and deoxypyridinoline)
• Treatment:
  General
  Calcium, vitamin D supplementation
  Weight bearing exercises, smoking cessation
  
  Medical therapy
  Raloxifene (mixed agonist/antagonist of estrogen receptors)
  Bisphosphonates
• Complications:
  Compression fractures
• Notes:
  One time screening for women 65 years and older with DEXA scan
• Associated With:
  Rheumatoid arthritis
  Postmenopausal women
  Turner's syndrome (from low estrogen levels)
• Risk Factors:
  Smoking
  ETOH
  Old age
  Asian/Caucasian
  Thin body habitus
  Steroid use