In the united states, millions of people either already have osteoporosis or are at high risk due to low bone mass. The pathogenesis of osteoporosis is complex and multifactorial 41,98. Osteoporosis is a skeletal disorder characterized by decreased mass and compromised bone strength predisposing to an increased risk of fractures. Pdf pathophysiology and pathomorphology of osteoporosis. Osteoblasts and osteocytes also produce opg, which is a decoy receptor for rankl and thus inhibits its actions on osteoclasts. Osteoporosis is a disease that thins and weakens the bones. Peak bone mass has a strong genetic component, with between 60 and 85% of the variance in bone mineral density bmd being attributable to genetic factors. Osteoporosis pathophysiology and clinical management. When converted to calcitriol most potent version main role is intestinal calcium absorption and works with pth to reelase ca. What is the most common osteoporosis pathophysiology. Bone strength is influenced by bone mass and bone quality where the latter comprises aspects of bone geometry, material properties, microstructure, and turnover. Pathogenesis of osteoporosis journal of clinical investigation.
Patterns of bone mass acquisition and loss in women and men. Here, learn about prevention, symptoms, treatments, and more. May 12, 2016 as explained in this post on the pathophysiology of osteoporosis, rankl, which is generated by osteoblasts and osteocytes, is a key regulator of osteoclast recruitment, activation, and survival. Although idiopathic osteoporosis is the most common form of osteoporosis, secondary factors may contribute to the bone loss and increased fracture risk in patients presenting with fragility fractures or osteoporosis. Osteoporosis causes bones to become weak and brittle so brittle that a fall or even mild stresses such as bending over or coughing can cause a fracture. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. A significant portion of the growing elderly population will be impacted by the disease current research indicates this is a growing drain on healthcare resources with a. Broken bones from osteoporosis cause serious health. These include wrist bones, hips, ribs, and bones in the vertebral column. The pathophysiology of osteoporosis is an imbalance between bone resorption and bone formation. The principal factors described are involved in two of the major tissues these being the cartilage and the synovial membrane implicated in the pathophysiology of this disease.
Osteoporosis is a common bone disease that will be frequently encountered by physical therapists. The principle cause of osteoporosis pathophysiology is an imbalance between two factors relating to maintenance of bone density. Pathophysiology of osteoporosis flashcards quizlet. This is accompanied by hypertrophic bone changes with osteophyte formation and subchondral bone plate thickening. May 30, 2015 osteoporosis has been called silent disease because bone mass is lost over many years with no sings or symptoms. Bone is living tissue that is constantly being broken down and replaced. Pathophysiology of osteoporosis new mechanistic insights laura a. Five major risk factors for osteoporosis have been identified. Apr 11, 2020 fractures related to osteoporosis tend to occur in bones which would not normally be vulnerable to damage from a simple fall. Overall schematic for the pathogenesis of osteoporosis. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
What is the role of estrogen deficiency in the pathogenesis. The hypothesis that osteoporosis is a consequence of. Estrogen deficiency not only accelerates bone loss in postmenopausal women but also plays a role in bone loss in men. Osteoporosis is most common in women after menopause, but anyone can develop it. Pdf osteoporosis is a classical agerelated disease that affects women more often than men. Forty years ago when albright first described the syndrome of postmenopausal osteoporosis he referred mainly to women with vertebral fractures.
Osteoporosis screening, diagnosis, and treatment guideline. A lifelong lack of calcium plays a role in the development of osteoporosis. Osteoporosis is a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fractures. In most cases, the disease is characterized by back pain from recurrent vertebral compressions, although fractures of the distal tibia, hip, ribs, or wrist can be the initial presentation. Most cases occur in postmenopausal women and older men. Pdf etiology and pathogenesis of osteoporosis researchgate. Osteoporosis is when theres a higher breakdown of bone in comparison to the formation of new bone which results in porous bones, meaning a decrease in bone density to the. Out of all the potential disease that may impact bones, osteoporosis is the most common. Too little vitamin d can lead to weak bones and increased bone loss. Irrespective of the epidemiology and pathogenesis of osteoporosis, the stark fact remains that this disease has significant morbidity and mortality. Osteoporosis, a chronic, progressive disease of multifactorial etiology see etiology, is the most common metabolic bone disease in the united states. Osteoporosis, defined by the world health organization who as a bone mineral density bmd tscore less than 2.
Osteoporosis is when theres a higher breakdown of bone in comparison to the formation of new bone which results in porous bones, meaning a. Osteoporosis affects mostly older women, but prevention starts when you are younger. Osteoporosis nih osteoporosis and related bone diseases. Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue with a. Pathophysiology is a term which describes the changes that occur when normal biological processes become abnormal. Recker, md, macp, faceb epidemiology of osteoporosis osteoporosis, defined by the world health organization who as a bone mineral. Terms in this set 17 what are the medications predisposing osteoporosis.
The epidemiology and pathogenesis of osteoporosis endotext. As with any disorder, a sound understanding of the pathophysiology of the underlying disease process is crucial to effective decision making regarding treatment. As the bone becomes more compromised fragility fractures will result. The pathophysiology and treatment of osteoporosis mayo. The con dition when bone mass drops to a critical level below which fracture risk is substantially higher is termed osteo porosis 17. Osteoporosis is a disorder in which loss of bone strength leads to fragility fractures. At the clinical stage of the disease, change in the synovial. Pathophysiology of osteoporosis seminars in nephrology. However, certain conditions may accelerate bone loss in patients with primary osteoporosis. International osteoporosis foundation2 osteoporosis has financial, physical, and psychosocial consequences, all of which significantly affect the individual, the family, and the community. Osteoporosis pathophysiology, therefore, refers to the changes that occur in the body as a result of osteoporosis. People with this condition suffer from a number of symptoms relating to loss of bone density, often as a result of longterm calcium deficiency. Raisz the skeleton is a metabolically active organ that undergoes continuous remodeling throughout life. Sep 12, 2003 osteoporosis and its complications have important detrimental effects on the quality of life of affected individuals.
Bone strength reflects the integration of 2 main features. Osteoporosis and its complications have important detrimental effects on the quality of life of affected individuals. The pathogenesis of oa involves a degradation of cartilage and remodelling of bone due to an active response of chondrocytes in the articular cartilage and the inflammatory cells in the surrounding tissues. Osteoporosis has also been associated with overactive parathyroid and adrenal glands. Rubin, md the three ages of women gustav klimt 1905. Understanding how bone remodeling is regulated is the key to the effective prevention and treatment of osteoporosis. Osteoarthritis oa is characterized by a degeneration of articular cartilage, in which the breakdown leads to matrix fibrillation, fissure appearance, gross ulceration, and fullthickness loss of the joint surface. No matter your age, you can take steps to build bone mass and prevent bone loss. Pathophysiology of osteoporosis trabecular and cortical bone loss in postmenopausal women ildnb003514 november 2014. Epidemiology, etiology, and diagnosis of osteoporosis american. Characterized by low bone mass and microarchitectural changes that increase the susceptibility to fracture, approximately 30 million postmenopausal women in the united states have either osteoporosis or osteopenia, and the incidence is likely to increase with the aging of the population.
The hypothesis that osteoporosis is a consequence of estrogen deficiency, has been proposed as early as 1941. Your signature will help to raise the profile of this silent disease, to make fracture prevention a global health priority. Active vitamin d, also called calcitriol, is more like a hormone than a. Osteoporosis musculoskeletal and connective tissue. It has been most frequently recognized in elderly white women, although it does occur in both sexes, all races, and all age groups. Peak bone mass is the major determinant of adult bone density. Rabiei m, masooleh is, leyli ek, nikoukar lr 20 salivary calcium concentration as a screening tool for postmenopausal osteoporosis. T1 the pathophysiology and treatment of osteoporosis.
This remodeling is necessary both to maintain the structural integrity of the skeleton and to subserve its metabolic functions as a storehouse of calcium and phosphorus. The causes of low bone mass primary osteoporosis postmenopausal or agerelated secondary osteoporosis caused wholly or. Osteoporosis is a classical agerelated disease that affects women more often than men. Although osteoporosis a term used to define decreased bone mass per unit volume of anatomical bone has become synonymous with decreased bone mineral density bmd, this feature is not always present. Physiology and pathophysiology of bone remodeling lawrence g. With more than 53 million americans at increased risk for bone fracture, its good to know that osteoporosis is a preventable and treatable disease. More than 95% of osteoporosis in women and about 80% in men is primary and therefore without an identifiable underlying cause. Glcocorticoids anticonvulsants heparin thyroid excessive ppi furosemide medroxyprogesterone acetate ai. Over time it compromises the strength and integrity of the bone. The pathophysiology and treatment of osteoporosis mayo clinic. Jul 22, 2019 osteoporosis is most common in women after menopause, but anyone can develop it. Testosterone replacement therapy can help improve symptoms of low testosterone, but osteoporosis medications have been better studied in men to treat osteoporosis and thus are recommended alone or in addition to testosterone.
Estrogen deficiency can lead to excessive bone resorption accompanied by. In osteoporosis, bone resorption takes place to a greater extent than bone formation, so a negative balance occurs with a net loss of bone and an accompanying increasing risk of fractures, resulting in deformity and chronic pain. The hypothesis that osteoporosis is a consequence of estrogen deficiency, has been proposed as early as 1941 by albright and colleagues 1. Osteoporosis has been called silent disease because bone mass is lost over many years with no sings or symptoms. In men, osteoporosis might be linked with a gradual agerelated decline in testosterone levels. Osteoporosis is a disease that leads to fragility fractures due to the loss of bone mass and bone microstructure. Who criteria for osteoporosis in women kanis ja et al, j bone miner res, 1994. Type ii osteoporosis or senile osteoporosis is observed in both sexes after the age of 70. Your bones become fragile and fracture break easily, especially the bones in the hip, spine, and wrist. Osteoporosis osteoporosis is a disease of the bones that causes.
As with many chronic diseases that express themselves late in life, osteoporosis is distinctly multifactorial, both in etiology and pathophysiology. Key clinical pointspostmenopausal osteoporosis fractures and osteoporosis are common, particularly among older women, and hip fractures can be devastating. As explained in this post on the pathophysiology of osteoporosis, rankl, which is generated by osteoblasts and osteocytes, is a key regulator of osteoclast recruitment, activation, and survival. Pathophysiology of osteoarthritis osteoarthritis and cartilage.
This continual resorption and redeposition of bone mineral, or bone remodeling, is intimately tied to the pathophysiology of osteoporosis. Pathophysiology of osteoarthritis osteoarthritis and. Pathophysiology of osteoporosis endocrinology and metabolism. Alterations in bone mineral density almost certainly represent the final common pathway by which pathologic factors affect risk of future osteoporotic fracture. Osteoarthritis is traditionally thought of as a wear and tear disease which occurs as we age. Bones, like the framework of an aircraft, have evolved to be light yet. Definitions osteoporosis is defined as low bone mass and microarchitectral deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. Recognition of both sides of this ambivalent definition is important, because, ultimately, the pathophysiology of osteoporosis involves the development of not only low bone mass but of both the other skeletal components of fragility and the extraskeletal factors that lead to fracture. Osteoporosis is more likely to occur in people who have.
This book is a completely revised and updated third edition, utilizing the most current evidence and practice guidelines for the treatment of osteoporosis and discussing the basic aspects of bone metabolism, pathophysiology, current diagnostic techniques and medical treatment strategies. Research has also shown that there is some continuity between bone and cartilage changes in oa, suggesting crosstalk between these tissues. Clinical definition and pathophysiology of osteoporosis. International osteoporosis foundation2 osteoporosis is one of the most common and debilitating chronic diseases, and a global healthcare problem. Osteoporosis is a clinical syndrome of reduced bone mass and increased fracture susceptibility. Learn the risk factors for osteoporosis, and what you can do to keep your bones strong and healthy. Osteoporosis related fractures most commonly occur in the hip, wrist or spine.