BM2405 HOSPITAL TRANNING

Osteoporosis
Presented to
Dr. Sachin Gaurishankar Sarate, Full time Doctor cum Assistant Professor, Department of Biomedical Engineering,
7/19/2012

Presented by
P.Sandhiya
31509121043

Introduction
Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones.
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Osteoporosis bone

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Bone in human body is generally classified into two types

Cortical Bone
Cortical bone, also known as compact bone Cortical bone is much denser with a porosity ranging between 5% and 10% Cortical bone is found primary is found in the shaft of long bones and forms the outer shell around cancellous bone at 7/19/2012 the end of joints and the vertebrae

Trabecular Bone
Trabecular bone, also known as cancellous or spongy bone Trabecular bone is much more porous with porosity ranging anywhere from 50% to 90% It is found in the end of long bones (see picture above), in vertebrae and in flat bones like the pelvis. Its basic first level structure is 4 the trabeculae.

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Osteoporosis Causes
Bone is continuously changing-a new bone is made and old bone is broken down-a process is called bone remodeling or bone turnover. A full cycle of bone remodeling takes about 2-3 months. Osteoporosis occurs when there is an imbalance between new bone formation and old bone resorption.
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 Two essential minerals for normal bone formation are calcium and phosphate. If a person does not take in enough calcium from their diet, the body extracts calcium from the bones, resulting in loss of bone strength and mass. This can ultimately lead to thin, fragile bones and osteoporosis..
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 The leading causes of osteoporosis are a drop in estrogen in women at the time of menopause and a drop in testosterone in men. Women over age 50 and men over age 70 have a higher risk for osteoporosis. The accelerated bone loss after menopause is a major cause of osteoporosis in women, referred to as postmenopausal osteoporosis.
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 Osteoporotic fractures usually occur in skeletal sites that are rich in trabecular bone. The most common low-energy fractures are those of the vertebrae, wrist and hip.

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The risk factors for osteoporosis

Risk Factors You Cannot Change
Gender Age Body size Ethnicity Family history

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 Risk Factors You Can Change

Hormonal deficiency Calcium deficiency Vitamin D deficiency Some medications use: e.g Corticosteroids Thyroid hormone Alcoholism Long-term physical inactivity ,etc.
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Symptoms:
There are no symptoms in the early stages of the disease. Symptoms occurring late in the disease include: Bone pain or tenderness Fractures with little or no trauma Loss of height (as much as 6 inches) over time
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 Low back pain due to fractures of the spinal bones Neck pain due to fractures of the spinal bones Stooped posture or kyphosis, also called a "dowager's hump"

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Radiological Diagnosis
Osteoporosis is defined as a progressive systemic skeletal disorder characterized by low bone mineral density (BMD), deterioration of the microarchitecture of bone tissue, and susceptibility to fracture. Bone mineral density (BMD) is determined by measuring the amount of bone mineral (calcium hydroxyapatite) per unit volume of bone tissue.
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 X-rays or gamma rays are often used to quantify BMD. Bone-density measurements can be performed by using X-ray methods, such as DEXA, QCT, and ultrasonic methods The most accurate way to diagnose osteoporosis is by measuring bone mass. Density measurements of the spine or hip are used.
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Radiography
The Singh index Single-photon absorptiometry (SPA)
SPA uses a single-energy source of gamma rays (iodine-125; photon energy, 27.3 keV) or Americium-241 (60 keV) to produce a collimated pencil beam.

Dual-photon absorptiometry (DPA)

The source of photons is153 Ga, which emits photons of 2 discrete energies (44 and 100 keV). The scanning approach is similar to that of SPA.
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 Single x-ray absorptiometry (SXA) Dual-energy x-ray absorptiometry (DEXA)

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DEXA image

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Computed Tomography
Bone-mineral density (BMD) measurements with a CT scanner have the major advantage that the trabecular component can be identified. The advantage of the CT methods is that the result is a true BMD and that it is measured only in the bone tissue of interest (trabecular bone). One major disadvantage of QCT is that artifacts hamper the CT data, reducing its 7/19/2012 21 accuracy.

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Magnetic Resonance Imaging

MRI is not yet in the mainstream use in the diagnosis of osteoporosis and is unlikely to become so because of its expense and the time required to obtain a scan. With recent advances in MRI, spatial resolutions of 80-150 m and a section thickness of 300-700 m can be achieved, allowing resolution of the trabecular structure
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 Ultrasonography
The ultrasound frequencies used are in the range of 0.1-1 MHz. This range has become known as BUA.

Nuclear Imaging
Radionuclide bone scans are particularly useful for screening the whole skeleton for abnormal activity at a site of osteoporotic fractures. The activity pattern is usually different in bony metastases

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 Treatment
Proper nutrition Exercise

Safety issues to prevent falls that may result in fractures.

Medications

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Alendronate (Fosamax) Risedronate (Actonel) Estrogen Therapy (ET) or Hormone Therapy (HT) Parathyroid Hormone or Teriparatide (Forteo),Etc..
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REFERENCE
http://emedicine.medscape.com/article/39 3602-overview#a01 http://www.ncbi.nlm.nih.gov/pubmedhealth /PMH0001400/ http://www.medicinenet.com/osteoporosis/ article.htm http://www.nlm.nih.gov/medlineplus/osteop orosis.html
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THANK YOU

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