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Diagnostics and treatment of osteoporosis

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, which is associated with reduced bone strength. This pathology affects all bones, which increases the risk of bone fractures under normal loads, usually in everyday situations. The most common skeletal system fractures are hip, distal radius fracture, vertebral fractures.

Highest risk group, first of all, are women in menopausal period because of their estrogen deficiency due to lower production of sex hormones. Further, osteoporosis can develop due to lower dietary intake of calcium and vitamin D, fluoride, phosphorus, protein, and excessive consumption of alcohol, caffeine, certain drugs (calcium antagonists, glucocorticoids), smoking and low physical activity.

Since osteoporosis is a consequence of exposure to a variety of factors, the types of diseases are the following:

1.  Primary Osteoporosis:

  • juvenile;
  • involutory (including postmenopausal);
  • hereditary;
  • idiopathic.

2. Secondary Osteoporosis:

  • diffuse connective tissue diseases;
  • endocrine disorders (hyperparathyroidism, diabetes mellitus, hyperthyroidism, hypogonadism);
  • gastrointestinal diseases; 
  • post-irradiation one; 
  • calcium deficiency;
  • immobilization;
  • hematologic and neoplastic disorders ( leukemia, multiple myeloma);
  • use of drugs that reduce the levels of calcium in the human body.

3. Local osteoporosis:

  • inflammatory diseases of the bones;
  • after traumas.

Clinically, osteoporosis is manifested by  pain, bone fracture, change in posture and skeletal deformities.

The methods used to diagnose osteoporosis:

1. X-ray- is effective in case of reducing bone mass more than 30%. Radiographic findings can suggest the presence of osteopenia, or bone loss in the affected area.

2. Densitometry is designed for quantitative assessment of bone density (BMD). There are several types of bone density tests:

  • dual-energy x-ray absorptiometry (DXA);
  • quantitative ultrasonography; 
  • quantitative computerized tomography. 

3. Baseline laboratory studies include the following:

  • TSH, T4- level;
  • ionised calcium level, 25-Hydroxyvitamin D level, measurement of intact parathyroid hormone;
  • level of sex hormones (for women - estradiol, testosterone, prolactin, etc .; men - free testosterone).

Patients with osteoporosis should be treated in specialized clinics.

Medical care also includes the identification and treatment of potentially treatable underlying causes of osteoporosis and consultation of doctors of various specialties (rheumatologist, cardiologist, and neurologist). But an endocrinologist playsthe most important role among them.

Stages of treatment of osteoporosis:

  1. Treatment of the underlying disease that caused osteoporosis (hypogonadism, hyperthyroidism, hypothyroidism).
  2. Therapy associated with increased bone mass (bisphosphonates, calcium supplements, vitamin D).
  3. Treatment for relieving pain (painkiller, etc).

In the medical centers of Belarus qualified doctors will provide you with highly professional assistance in the treatment of osteoporosis.


Hospitals

State Establishment «The Republican Center of Medical Rehabilitation and Balneotherapy»