Signs and Symptoms, Fractures, and Complications - Osteoporosis is often asymptomatic until a bone is broken. - Fractures from osteoporosis occur in situations where healthy people wouldn't normally break a bone. - Common fragility fractures occur in the vertebral column, rib, hip, and wrist. - People with osteoporosis may experience acute and chronic pain. - Vertebral collapse can cause sudden back pain, radicular pain, and loss of height. - Fractures are a common symptom of osteoporosis. - Osteoporotic fractures can result in disability and early mortality. - Fractures may be asymptomatic. - Common osteoporotic fractures occur in the wrist, spine, shoulder, and hip. - Multiple vertebral fractures can lead to a stooped posture and reduced mobility. - Osteoporosis can lead to disability and increased risk of death after fractures. - Decreased quality of life and increased healthcare costs are associated with osteoporosis. - Fractures from osteoporosis can result in disabilities. - Osteoporosis can have financial costs to healthcare systems. - Osteoporosis is a recognised complication of specific diseases and disorders.

Risk Factors - Age and sex are risk factors for osteoporosis. - Nonmodifiable risk factors include advanced age and female sex. - Ethnicity, particularly European or Asian ancestry, predisposes individuals to osteoporosis. - Family history of fracture or osteoporosis increases the risk. - Medication use can also contribute to osteoporosis risk.

Potentially Modifiable Factors - Alcohol intake greater than three units/day may increase the risk of osteoporosis. - Consuming 0.5-1 drinks a day may have 1.38 times the risk compared to non-alcohol consumers. - Low circulating Vitamin D is common among the elderly worldwide. - Mild vitamin D insufficiency is associated with increased parathyroid hormone production. - Tobacco smoking is associated with decreased bone health. - Smoking inhibits the activity of osteoblasts. - Smoking is an independent risk factor for osteoporosis. - Malnutrition plays a role in maintaining good bone health. - Risk factors include low dietary calcium, phosphorus, and other essential nutrients. - Imbalance of omega-6 to omega-3 polyunsaturated fats is a risk factor. - Physical inactivity can lead to significant bone loss. - Weight-bearing exercise increases peak bone mass achieved in adolescence. - Endurance training can lead to decreased bone density in female athletes. - Cadmium and lead exposure are strongly associated with bone disease. - Soft drinks may increase the risk of osteoporosis in women. - Proton pump inhibitors can increase the risk of bone fractures.

Medical Disorders - Immobilization causes bone loss. - Localised osteoporosis can occur after prolonged immobilization. - Hypogonadal states can cause secondary osteoporosis. - Estrogen deficiency is a common cause of osteoporosis in females. - Testosterone deficiency is a cause of osteoporosis in males. - Endocrine disorders such as Cushing's syndrome and hyperparathyroidism can induce bone loss. - Malnutrition and malabsorption can lead to osteoporosis. - Rheumatologic disorders increase the risk of osteoporosis. - Chronic kidney disease can lead to renal osteodystrophy. - Hematologic disorders such as multiple myeloma are linked to osteoporosis. - Several inherited or genetic disorders are linked to osteoporosis. - Scoliosis of unknown cause is associated with a higher risk of osteoporosis. - Bone loss can be a feature of complex regional pain syndrome. - Parkinson's disease is associated with a higher risk of broken bones. - People with Parkinson's disease may experience altered calcium metabolism.

Medication - Glucocorticosteroids and anticonvulsants are associated with an increase in osteoporosis risk. - Prednisone, a synthetic glucocorticoid prescription drug, is a main candidate for steroid-induced osteoporosis (SIOP) after prolonged intake. - Some guidelines recommend prophylaxis in patients taking the equivalent of more than 30mg hydrocortisone (7.5mg of prednisolone) for more than three months. - Calcium or Vitamin D is recommended for prevention. - Barbiturates, phenytoin, and some other antiepileptics may accelerate the metabolism of vitamin D. - L-Thyroxine over-replacement may contribute to osteoporosis, similar to thyrotoxicosis. - Several drugs induce hypogonadism, such as aromatase inhibitors, methotrexate, depot progesterone, and gonadotropin-releasing hormone agonists. - Long-term use of heparin is associated with a decrease in bone density. - Warfarin and related coumarins have been linked to an increased risk of osteoporotic fracture in long-term use. - Proton pump inhibitors inhibit stomach acid production, potentially interfering with calcium absorption. - Chronic phosphate binding may occur with aluminium-containing antacids. - Thiazolidinediones (used for diabetes) like rosiglitazone and pioglitazone have been linked to an increased risk of osteoporosis and fracture. - Chronic lithium therapy has been associated with osteoporosis.