Condition Info - BotMed Application

ConditionName

Osteoporosis

ConditionDescription

Symptoms

Chronic, poorly localized back pain; postmenopausal; slight build; history of inactivity or endocrine disorder
Fractures; Falls; Loss of height; Spontaneous fractures of weigh bearing bones

PhysicalFindings

Palpable tenderness over area or compression fracture; kyphosis or lordosis; loss of height

ClinicalTests

Bone densitometry; spinal radiograph to r/o fracture 
Routine DEXA scan >65 – most accurate test;
Osteopenia: bone density (T-score) is between 1 and 2.5 standard deviation below normal;
Osteoporosis: T-score > 2.5 standard deviation < normal;
LABS ARE NORMAL!

RiskFactors

Elderly;
Female;
Osteopenia;
White; Asian;
Low weight;
Low dietary calcium;
Smoking; Alcohol;
Sedentary lifestyle;
Low estrogen; Low testosterone;
History of steroids;
Hyperparathyroidism;
Hyperthyroidism;
Lon use of corticosteroids; 

Medication: 
Aromatase inhibitors;
Anticoagulants (unfractionated and low molecular weight heparins);
Antiretroviral therapy;
Cyclosporine;
Depot medroxyprogesterone acetate;
Corticosteroids therapy, (at least 3 months cumulative therpave in the previous year at a prednisone equivalent dose > 7.5mg daily);
Loop diuretics;
Proton pump inhibitors (PPIs);
SSRIs;
Thiazolidinediones;
High dose vitamin A are associated with increased risk of hip fracture so patients should not take double doses of multivitamins to try to increase their vitamin D intake.

IsRedFlag

IsNPLEX

Consequence

Colles fracture:
Distal radial +/- distal ulna

ProgressionFromCondition

TreatmentOptions

Exercises; Weigh bearing exercises

PharmOptions

osteonecrosis of jaw, can cause pill esophagitis)
Relaxifene

Vitamins D, K2, calcium – best initial therapy
Estrogen replacement – post meno female

Calcitonin decreases vertebral fracture risk

WebLink

https://www.merckmanuals.com/en-ca/professional/musculoskeletal-and-connective-tissue-disorders/osteoporosis/osteoporosis