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.

Osteoporosis (Wikipedia)

Not to be confused with Osteosclerosis.

Osteoporosis is a systemic skeletal disorder characterised by low bone mass, micro-architectural deterioration of bone tissue leading to bone sterility, and consequent increase in fracture risk. It is the most common reason for a broken bone among the elderly. Bones that commonly break include the vertebrae in the spine, the bones of the forearm, the wrist, and the hip. Until a broken bone occurs there are typically no symptoms. Bones may weaken to such a degree that a break may occur with minor stress or spontaneously. After the broken bone heals, the person may have chronic pain and a decreased ability to carry out normal activities.

Osteoporosis
Elderly woman with osteoporosis showing a curved back from compression fractures of her back bones.
Pronunciation	/ˌɒstioʊpəˈroʊsɪs/
Specialty	Rheumatology, Endocrinology, orthopedics
Symptoms	Increased risk of a broken bone
Complications	Chronic pain
Usual onset	Older age
Risk factors	Alcoholism, anorexia, European or Asian ethnicity, hyperthyroidism, gastrointestinal diseases, surgical removal of the ovaries, kidney disease, smoking, certain medications
Diagnostic method	Dexa Scan (Bone density scan)
Treatment	Good diet, exercise, fall prevention, stopping smoking
Medication	Bisphosphonates
Frequency	15% (50 year olds), 70% (over 80 year olds)

Osteoporosis may be due to lower-than-normal maximum bone mass and greater-than-normal bone loss. Bone loss increases after the menopause due to lower levels of estrogen, and after "andropause" due to lower levels of testosterone. Osteoporosis may also occur due to a number of diseases or treatments, including alcoholism, anorexia, hyperthyroidism, kidney disease, and surgical removal of the ovaries. Certain medications increase the rate of bone loss, including some antiseizure medications, chemotherapy, proton pump inhibitors, selective serotonin reuptake inhibitors, and glucocorticosteroids. Smoking, and too little exercise are also risk factors. Osteoporosis is defined as a bone density of 2.5 standard deviations below that of a young adult. This is typically measured by dual-energy X-ray absorptiometry (DXA or DEXA).

Prevention of osteoporosis includes a proper diet during childhood, hormone replacement therapy for menopausal women, and efforts to avoid medications that increase the rate of bone loss. Efforts to prevent broken bones in those with osteoporosis include a good diet, exercise, and fall prevention. Lifestyle changes such as stopping smoking and not drinking alcohol may help. Bisphosphonate medications are useful to decrease future broken bones in those with previous broken bones due to osteoporosis. In those with osteoporosis but no previous broken bones, they are less effective. They do not appear to affect the risk of death.

Osteoporosis becomes more common with age. About 15% of Caucasians in their 50s and 70% of those over 80 are affected. It is more common in women than men. In the developed world, depending on the method of diagnosis, 2% to 8% of males and 9% to 38% of females are affected. Rates of disease in the developing world are unclear. About 22 million women and 5.5 million men in the European Union had osteoporosis in 2010. In the United States in 2010, about 8 million women and between 1 and 2 million men had osteoporosis. White and Asian people are at greater risk. The word "osteoporosis" is from the Greek terms for "porous bones".