Answer
DNB Orthopaedics December 2015 Paper I - Osteoporosis
Question
a) Classify osteoporosis. (3+(3+4) marks)
b) Clinical presentation and management of senile osteoporosis.
a) Classification of Osteoporosis
Definition: Osteoporosis is a systemic skeletal disorder characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to increased bone fragility and susceptibility to fracture.
1. Primary Osteoporosis
- Type I (Postmenopausal osteoporosis): Occurs predominantly in women within 10–15 years after menopause, due to estrogen deficiency causing increased bone resorption, mainly affecting trabecular bone.
- Type II (Senile osteoporosis): Occurs in both sexes, usually after 70 years of age, related to aging processes causing decreased bone formation and reduced osteoblast function, affecting both cortical and trabecular bone.
- Idiopathic osteoporosis: Rare, seen in younger individuals without obvious cause, can be further subclassified into juvenile or adult idiopathic osteoporosis.
2. Secondary Osteoporosis
Results from identifiable causes or comorbidities affecting bone metabolism. These include:
- Endocrine disorders: e.g., hyperparathyroidism, hyperthyroidism, Cushing’s syndrome, diabetes mellitus.
- Drugs: Long-term corticosteroids, anticonvulsants, heparin, thyroxine overdose.
- Malabsorption and nutritional deficiencies: Celiac disease, chronic liver disease, vitamin D deficiency.
- Chronic diseases: Chronic kidney disease, rheumatoid arthritis, immobilization.
- Others: Alcoholism, hematological disorders like multiple myeloma.
Summary Table: Classification of Osteoporosis
| Type | Age / Population | Pathophysiology |
|---|