What is involutive osteoporosis and treated if he
Osteoporosis is a systemic bone disease characterized by lesions of its architectonics and manifested by increased fragility of the skeleton and recurrent fractures.
The Primary involutive osteoporosis is divided into two types:
- Postmenopausal – women manifests itself within 9-12 years after menopause. Characterized by a loss of 30% compact and 55% of the spongy tissue. This is due to the involution of the ovaries and consequently by a decrease in the secretion of estrogen.
- Senile causes are decrease calcium resorption in the intestine, a decrease in the synthesis of vitamin D by 50-60%, the increase in the number of osteoclasts (cells that destroy bone) and growth inhibition of osteoblasts (cells that form the skeleton).
for a Long time the disease is latent, i.e., asymptomatic. Skeletal tissue has no nerve endings, so pain does not normally arise. But when senile osteoporosis due to the very low bone density and micro traumas of the trabeculae may appear ossalgia.
The First manifestation of the disease in most cases is a fracture that occurs without symptoms or with minor trauma.
The Most frequent localization of fractures for osteoporosis are:
- vertebral bodies in the thoracic and lumbar
- the distal bone of the forearm (broken Wheel and Smith)
- proximal femur (fracture of the surgical neck of the femur).
Characteristic features of senile type is considered the appearance of the so-called "widow's hump" (kyphosis of dorsal spine).
Feature type is postmenopausal tooth loss (edentulism) due to the destruction of the alveolar processes of the jaw.
Diagnosis and treatment
The Main method of diagnosis of pathology – radiography of the skeleton. The main radiographic signs are:
- thinning and increase the contrast of the closing plates of the vertebrae;
- reduction of the cortical layer of tubular bones;
- increase transparency of the bone tissue and the deformation of the transverse trabeculae;
- wedge-shaped or biconcave deformity of the vertebral bodies ("fish" vertebrae).
Also to assess the status of bone tissue structure doctor may order a dual energy x-ray absorbtiometry (method evaluates the content of the mineralized skeletal tissue per unit area), densitometry (describes bone mineral density), ultrasonometry and CT scan.
Laboratory studies include the determination of levels of electrolytes (total and ionized calcium, magnesium, inorganic phosphorus), parathyroid hormone, calcitonin.
For the diagnosis of primary involutive osteoporosis it is necessary to exclude diseases that cause secondary process:
- diseases of endocrine organs (Itsenko syndrome-Cushing's, hyperparathyroidism, diabetes mellitus)
- pathology of the gastro-intestinal tract (malabsorption syndrome, post-bowel resection);
- systemic connective tissue diseases (rheumatoid arthritis)
- kidney disease (Fanconi syndrome, chronic renal failure).
The disease cannot be completely cured, can only slow the progression of the process and try to prevent fractures. To do this, use hormone replacement therapy (estrogen), calcium supplements (calcium gluconate), synthetic analogues of vitamin D (alfacalcidol).