A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height [reduction in height]; further: Inspection (viewing). Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait pattern (fluid, limping) [gait insecurity due to faulty statics and shift in center of … Osteoporosis: Examination
1st order laboratory parameters – obligatory laboratory tests (unless otherwise shown). Blood tests Blood count ESR (erythrocyte sedimentation rate) or CRP (C-reactive protein). Serum calcium Serum phosphate Serum creatinine, creatinine clearance if applicable. Alkaline phosphatase (AP) Gamma-GT TSH (thyroid-stimulating hormone) Serum electrophoresis If necessary, hydroxy vitamin D3 (as a case-by-case decision). Testosterone in men (optional; … Osteoporosis: Test and Diagnosis
Therapy target Avoidance of complications and further progression of bone destruction. Therapy recommendations Therapy scheme (applicable to DXA values only). Age in years T-score (applicable to Dexa values only. The efficacy of pharmacotherapy has not been proven with certainty for peripheral fractures (broken bones) with a T-score > -2.0) Ms Man -2,0 – -2,5 -2,5 … Osteoporosis: Drug Therapy
Obligatory medical device diagnostics. Osteodensitometry (bone densitometry) – for early diagnosis of osteoporosis and follow-up of therapy, bone density can be determined as follows: Dual X-ray absorptiometry (DXA, DEXA; dual X-ray absorptiometry; method of first choice). Quantitative computed tomography (QCT) Quantitative ultrasonography (QUS) Optional medical device diagnostics – depending on the results of the history, … Osteoporosis: Diagnostic Tests
Within the framework of micronutrient medicine (vital substances), the following vital substances (macro- and micronutrients) are used for prevention and supportive therapy: Calcium is an essential component of bones. Therefore, it is essential to ensure a calcium-rich diet. In addition, calcium supplements can be used. In order for the body to properly absorb and utilize … Osteoporosis: Micronutrient Therapy
1st order Often, after fractures (broken bones), surgical therapy must be performed to restore the stability of the bone. This mainly concerns fractures of the hip and thigh. For fractures of the vertebral bodies, the type of therapy depends on whether the fracture is stable or unstable. In stable fractures, it is usually sufficient to … Osteoporosis: Surgical Therapy
Before puberty, the skeletal system develops predominantly without the influence of sex hormones, with bone growth controlled by genetic predisposition responsible for 60-80% of bone mass and fracture resistance (“bone fracture resistance”), the calcium–vitamin D system, and physical stress. The situation changes with the onset of puberty. During puberty, the skeletal system becomes sex hormone … Osteoporosis: Physiology
To prevent osteoporosis, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet High intake of sodium and table salt – High intake of table salt with subsequent increase in natriuresis promotes hypercalciuria and thus negative calcium balance. A 2.3 g increase in sodium intake results in a 24-40 mg increase in … Osteoporosis: Prevention
Osteoporosis does not cause pain. Only when fractures* (broken bones) have occurred can the following symptoms occur: Pain – osteoporotic fracture pain is severe and lasts for approximately four to six weeks, until the fracture is consolidated (longer if the fractures do not heal). Typically, there is a concussion sensitivity of the spine (head sensitivity) … Osteoporosis: Symptoms, Complaints, Signs
Pathogenesis (disease development) The maximum bone mass (peak bone mass) is reached in the 30th to 35th year of life and is 60-80% genetically predetermined. In normal bone metabolism, there is a steady balance between bone resorption and bone formation. This balance is maintained until about the age of 40. After that, the body loses … Osteoporosis: Causes
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Ehlers-Danlos syndrome – genetic disorder characterized primarily by hyperextensibility of the joints and typical skin changes. Marfan syndrome – genetic disease, which can be inherited both autosomal dominant or occur sporadically (as a new mutation); systemic connective tissue disease, which is characterized mainly by tall stature, spider limbs … Osteoporosis: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by osteoporosis: Respiratory system (J00-J99) Limitation of lung function due to fractures (broken bones) in the thoracic spine. Cardiovascular system (I00-I99) Limitation of cardiac function due to fractures in the thoracic spine. Heart failure (cardiac insufficiency) Coronary artery disease (CAD; coronary … Osteoporosis: Complications