Osteoporosis: Clinical Presentation and Diagnosis

by Carlo Raj, MD

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    Clinical presentation: Most patients may be in some... asymptomatic until there is a massive fracture of either the vertebrae or maybe perhaps the hip that I had mentioned earlier. There are greater than one inch loss of height; kyphosis because of issues within the vertebrae and with that kyphosis may then cause restriction of your thoracic cavity, thoracic cage. So, therefore, breathing becomes difficult; may result in even restrictive lung disease because of literally physical, mechanical restriction of your lung. Focused exam looking for signs of secondary causes, always is in endocrinopathy; is your patient corticoid, so on and so forth. Imaging: plain film, not sensitive for detecting early disease... not early on, your bone may actually still look rather normal. Lateral films used for-for visualizing spine compression fractures. Remember osteopenia, would mean decreased or thinning out of your trabeculae. There?s something called dual-energy X-ray absorp-absorptiometry known as the DXA scan. So, DXA scan, calculated bone mineralized density; bottom-line, that?s what a DXA scan will do. It will find out as to how dense your bone is. So, therefore, once, let?s say a female, has hit menopause, you can expect the DXA scan to show you decreased bone density. Measures bone-bone density; mineralization at the spine and your hip, two major sites that you worried about major fractures in a patient with osteoporosis. Low bone mineralization density correlates with increased risk of fracture. Results express in the following two scores: we have a T-score. You want to be at least familiar with what these mean and when you would even use this or apply this. A T-score will be used in a patient who you suspect an osteoporosis with your bone mineralization density, expressed in number of standard deviation above or below the mean of normal 30-year old patient. Then...

    About the Lecture

    The lecture Osteoporosis: Clinical Presentation and Diagnosis by Carlo Raj, MD is from the course Bone Disease.

    Included Quiz Questions

    1. Restrictive lung disease
    2. Hip fracture
    3. Hypercalcemia
    4. Vertebral compression fracture
    5. Endocrine abnormalities
    1. Scan completed at 2 sites- the spine and the knee
    2. Calculates bone density
    3. Expressed as 2 scores
    4. Uses photon beams of 2 different energy levels
    5. Involves comparison to an average mean of a 30 year old patient
    1. Osteopenia
    2. Normal BMD
    3. Osteoporosis
    4. Severe osteoporosis
    5. Severe osteopenia
    1. A patient that has been diagnosed with osteopenia
    2. 63 year old woman in good health
    3. 60 year old man with clinical risk factors
    4. A patient who is on hormone replacement therapy
    5. A patient with no history of osteoporotic fracture

    Author of lecture Osteoporosis: Clinical Presentation and Diagnosis

     Carlo Raj, MD

    Carlo Raj, MD

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