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Osteoporosis

2018-03-28

One, what is osteoporosis?


It is a systemic bone metabolism disorder in which the microstructure of bone tissue is damaged, the proportion of bone mineral components and bone matrix is continuously reduced, the bone thickness is thinned, the number of trabecular bone is reduced, the bone fragility is increased, and the fracture risk is increased. disease. In medicine, osteoporosis was first proposed by Pornmer in 1885. It was not until 1990 at the International Osteoporosis Symposium held in Denmark that osteoporosis had a clear definition and was recognized by the world. : Primary osteoporosis is a systemic skeletal disease characterized by reduced bone mass and degraded bone microstructure, resulting in increased brittleness of the bone and prone to fracture. Mainly manifested as: reduced bone mass, osteocalcium dissolution, spinal compression fractures, resulting in the emergence of "turtle back", accompanied by dyspnea, bone hyperplasia, hypertension, Alzheimer's disease, diabetes and other senile diseases; bone microscopic The structure is degraded, the strength of the bone is reduced, the brittleness is increased, and it is difficult to carry the original load.


Second, the symptoms of osteoporosis


1, pain. The most common symptom of primary osteoporosis is low back pain, which accounts for 70%-80% of patients with pain. Pain spreads along both sides of the spine, relieves pain when lying supine or sitting, stretches when standing upright or standing, pain increases when sitting sedentary, pain during the day is light, aggravates at night and wake up in the morning, bends, muscle exercises, cough, When the stool becomes harder, it increases. Bone pain usually occurs when bone mass is lost by more than 12%. In senile osteoporosis, the trabecular bone trabecula shrinks, the number decreases, the vertebral body compresses and deforms, the spine flexes, and the carbyngeal muscle corrects the forward flexion of the spine, doubles the contraction, muscle fatigue and even spasm, and produces pain. Newly-thoracic and lumbar compression fractures can also produce acute pain. The corresponding site of spinous process may have intense tenderness and percussion pain, which can be gradually relieved after 2-3 weeks. Some patients may present with chronic low back pain. If the compression of the corresponding spinal nerve can produce limb radiating pain, lower limbs, sensorimotor disorders, intercostal neuralgia, poststernal pain similar to angina, abdominal pain may also occur similar to acute abdomen. If the compression of the spinal cord and cauda equina affect the bladder and rectum function.


2, length shortened, humpback. Mostly after pain. The anterior part of the spine is composed mostly of cancellous bone, and this part is the mainstay of the body. It has a large weight, especially the 11th and 12th thoracic vertebrae and the third lumbar vertebrae. The load is greater, and it is easily compressed and deformed, causing the spine to lean forward. The dorsiflexion is exacerbated and forms a hunchback. As the age increases, osteoporosis increases, and the curvature of the humpback increases, resulting in significant knee distraction. Each person has 24 vertebrae, and the height of each vertebral body of a normal person is about 2 cm. When the elderly are osteoporotic, the vertebral body is compressed, and each vertebral body is shortened by about 2 mm, and the average body length is shortened by 3-6 cm.


3, fractures. This is the most common and serious complication of degenerative osteoporosis.


4, decreased respiratory function. Thoracic and lumbar compressive fractures, posterior curvature of the spine, and thoracic deformity can significantly reduce vital capacity and maximal ventilation, and patients may develop chest tightness, shortness of breath, and difficulty breathing.


Third, risk factors for osteoporosis include


Gender (especially women), race (especially whites and Asians), fine bone structure, low body mass index (BMI), smoking, alcohol abuse, lack of activity, family history.


Fourth, diagnosis


Ickrey dual-energy X-ray bone density testing is the gold standard for the diagnosis of osteoporosis. Osteoporosis can be diagnosed if the measured bone mineral density is less than the standard deviation of the young person by 2.5 standard deviations (which can be expressed as a T-value). The World Health Organization established the following diagnostic criteria:


T-value greater than -1.0 is normal,


T-values between -1.0 and -2.5 are "low bone density"


The T value is less than -2.5 for osteoporosis.


If there is a fall or fracture event due to low bone density, severe osteoporosis (or confirmed osteoporosis) may be considered.


The International Society for Clinical Densitometry says: 1. Diagnosis of osteoporosis in men under 50 years of age cannot be based solely on the results of density tests. 2. For premenopausal women, the Z value should be used (comparison with the same age group). Rather than the value of the peak bone mineral density, not the T value. At the same time, the diagnosis of these women cannot be based solely on the density test results.


Five, osteoporosis misunderstanding


1. Osteoporosis does not require bone density determination.


Bone mineral density measurement can be used not only for the diagnosis of osteoporosis, but also for the follow-up of osteoporosis changes and evaluate the effectiveness of osteoporosis drug treatment. Therefore, patients with osteoporosis have been confirmed to regularly perform bone mineral density measurements. Understand changes in osteoporosis and evaluate the effectiveness of osteoporosis medications. In general, bone density can be checked once a year.


2. No fracture will occur if there is no history of trauma.


Bones with osteoporosis are very fragile, and some minor movements are often not perceived (that is, there is no apparent history of trauma), but can cause bone fractures: coughing, sneezing, lifting heavy objects or holding children, or even breathing hard... ... Common fractures: vertebrae, ribs, sacrum, and upper femur. These minor fractures can have serious consequences for the patient. Therefore, early diagnosis and timely treatment should be performed.


3. Osteoporosis is caused by natural aging without treatment.


With the prolongation of human life, the aging population continues to increase, and the incidence of some age-related diseases is also increasing year by year. The four major diseases that the elderly need to pay attention to are: hypertension, hyperlipidemia, diabetes, and osteoporosis. The occurrence of these diseases is related to aging. It can also be said to be related to natural aging, but it does not require treatment or treatment. In fact, these diseases can be prevented and treated. Osteoporosis can be achieved through lifestyle intervention, calcium supplementation, and if necessary, combined with drug therapy to reduce the patient's pain and prevent the occurrence of fractures, thereby improving the quality of life of the elderly. And extend its life.


4, osteoporosis treatment can only delay the loss, can not increase bone density.


According to clinical practice, a considerable number of patients with osteoporosis after a reasonable treatment, review showed increased bone density, indicating that treatment not only stops the loss of bone, but also can improve the quality of bone.


5, prevention and treatment of osteoporosis, eat calcium tablets is sufficient.


Calcium is the key to keeping bones strong but not the only one needed. The purpose of drug control is to inhibit bone resorption and promote bone formation. Maintaining a healthy lifestyle, a reasonable diet, moderate exercise, and constant exposure to the sun are also important, and they cannot be replaced by drugs.


6, osteoporosis is a minor disease, treatment does not need to make a fuss.


Osteoporosis is usually more than just backache and leg pain. Once a fragility fracture occurs, especially in elderly patients with hip fractures, resulting in long-term bed rest, the mortality rate is very high.

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