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Causes and risk factors
- Lifestyle factors - low calcium intake, vitamin D deficiency, excess vitamin A intake, inadequate physical activity, smoking, and alcohol abuse
- Genetic factors - parental history of hip fracture.
- Endocrine disorders associated: - hyperparathyroidism, hypogonadal states, anorexia nervosa, diabetes mellitus, Cushing syndrome, excess thyroid hormone
Making the diagnosis
Make clinical diagnosis of Osteoporosis in adults with fragility fracture, regardless of any test results
If no fragility fracture consider screening for Osteoporosis with bone mineral density testing measurement at posterior-anterior spine and/or hip) in:
- All women 65 y of age or older
- All postmenopausal women
- With a history of fracture(s) without major trauma after age 40 to 45 Y
- With osteopenia identified radiographically
- Starting or taking long-term systemic glucocorticoid therapy (≥3 mo)
- Other perimenopausal or postmenopausal women with risk factors for osteoporosis if willing to consider pharmacologic interventions
- Low body weight (<127 lb or body mass index <20 kg/m2)
- Ever use of long-term systemic glucocorticoid therapy (≥3 mo)
- Family history of osteoporotic fracture
- Early menopause
- Current smoking
- Excessive consumption of alcohol
- Secondary Osteoporosis: Diabetes mellitus, Alcoholism, Rheumatoid arthritis etc.
Treatment overview
- Lifestyle recommendations for all patients
- Balanced diet with adequate calcium and vitamin D intake
- Regular weight-bearing and muscle-strengthening exercise to improve agility, strength, posture, and balance, increase bone mineral density, and reduce risk of falls and fractures
- Smoking cessation
- Avoid excess alcohol intake
