هشاشة العظام

Definition

Osteoporosis is low bone density with damaged microarchitecture, making bone fragile and easy to break.

Risk factors

• Postmenopausal women (oestrogen loss)
• Older age, low body weight, family history
• Smoking, alcohol, inactivity
• Long-term steroids
• Low calcium and vitamin D

Symptoms

Silent until a fracture, most often of the hip, spine or wrist. Vertebral fractures can cause height loss and kyphosis.

Diagnosis

Bone density (DEXA): a T-score of -2.5 or lower means osteoporosis; between -1 and -2.5 means osteopenia.

Treatment

• Calcium and vitamin D
• Bisphosphonates such as alendronate first line
• Denosumab, or bone-building drugs in severe cases

Nursing care

• Fall prevention: lighting, removing rugs, stable footwear
• Weight-bearing and balance exercise
• Teach correct alendronate technique

Exam point

Alendronate: morning, empty stomach, full glass of water, stay upright 30 minutes.