A S E M S H A D I D

PBL 1 - MS

HORMONAL THERAPY AND OSTEOPOROSIS

• Hormone Therapy (HT) or estrogen/progesterone, is commonly used to relieve the symptoms of menopause.

• Following menopause, the body produces much less of the sex hormones estrogen and progesterone, resulting in a loss of bone density.

• In women, bone loss occurs rapidly in the perimenopausal years. Bone loss can eventually lead to osteoporosis (or thin bones).

• osteoporosis can progress without pain or symptoms until a bone breaks (fractures). Fractures commonly occur in the hip .

• Half of women and a quarter of men older than 50 years will have an osteoporosis-related fracture in their lifetime.

• Men in their fifties do not experience the rapid loss of bone mass that women do in the years following menopause. By age 65 or 70, however, men and women are losing bone mass at the same rate .

DIAGNOSING BONE DISORDERS

• X-ray. An X-ray can show injuries, such as fractures, infections, arthritis, and other changes.

• Bone densitometry. Bone densitometry is often used to detect osteoporosis. The test measures bone mass in the spine, hips, and arms. These are the areas most likely to fracture when bone mass is low.

CON.

• Computed tomography scan (also called a CT or CAT scan). A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

• Magnetic resonance imaging (MRI). An MRI scan provides detailed images of soft tissue, the bone marrow cavity, and bone tumors.

• Radionuclide bone scan. The bone scan is used to pinpoint the location of bone tumors, as well as to detect spread to other bones. It's also used to diagnose stress fractures or tiny cracks in the bones

• Biopsy. Tissue samples are removed and examined under a microscope. It's done to determine if cancer or other abnormal cells are present. Two types of biopsy, including:

• Needle biopsy. A needle is inserted into the bone to obtain tissue.• Open biopsy. A surgical procedure in which an incision is made

through the skin to and allow a sample of tissue to be cut or scraped away.

OSTEOPOROSIS

• Osteoporosis is a term that describes the loss of calcium from bones resulting in bones that are thin.

• Osteoporosis is a disease where decreased bone strength increases the risk of a broken bone.

CON. OSTEOPOROSIS

• Osteopenia is the forerunner -تسبق - of osteoporosis. It is a silent but destructive condition that robs bones during a woman's -- even a young woman's -- most productive time.

• Until a broken bone occurs there are typically no symptoms.In fact, there are usually no visible signs.

• Risk factors for osteoporosis include aging, being female, low body weight, low sex hormones or menopause, smoking, and some medications.

• Prevention and treatment include calcium and vitamin D, exercise, and osteoporosis medications.

CON. OSTEOPOROSIS • What Are Osteoporosis

Symptoms?

• Osteoporosis often progresses without symptoms or pain. Losing height may be noticeable. Or a Dowager's hump in your spine may develop with age.

• Osteoporosis itself has no symptoms; its main consequence is the increased risk of bone fractures.That fracture is often in the back or hips.

HOW DO I KNOW IF I HAVE OSTEOPOROSIS?.

• How Do I Know if I Have Osteoporosis?

• First, check your risk factors. Then, ask your health care provider about a bone mineral density (BMD) test.

• BMD : is the amount of bone mineral in bone tissue.

• Results are often reported in 3 terms:• Measured areal density in g cm−2• z-score, the number of standard deviations

above or below the mean for the patient's age, sex and ethnicity

• t-score, the number of standard deviations above or below the mean for a healthy 30-year-old adult of the same sex and ethnicity as the patient

CON.

• there are many different types of BMD tests Dual-energy X-ray absorptiometry (DXA or DEXA) is currently the most widely used .

• Results :

• Results are generally scored by two measures, the T-score and the Z-score. Scores indicate the amount one's bone mineral density varies from the mean. Negative scores indicate lower bone density, and positive scores indicate higher.

CON.• The criteria of the World Health Organization are:

• T-score is the relevant measure when screening for osteoporosis. It is the bone mineral density (BMD) at the site when compared to the young normal reference mean.

• Normal is a T-score of −1.0 or higher• Osteopenia is defined as between −1.0 and −2.5• Osteoporosis is defined as −2.5 or lower, meaning a bone density that is

two and a half standard deviations below the mean of a thirty-year-old man/woman.

• The Z-score is the comparison to the age-matched normal and is usually used in cases of severe osteoporosis. This is the number of standard deviations a patient's BMD differs from the average BMD of their age, sex, and ethnicity.

IN OTHER WORD ..

ANATOMY AND HISTOLOGY OSTEOPOROSIS

Illustration depicting normal standing posture and osteoporosis

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