Osteoporosis is progressive, systemic skeletal disorder characterized by loss of bone tissue and disruption of bone micro-architecture which leads to bone fragility and a consequent increased risk of fracture. It is usually an age-related disease and diagnosed by bone density T-score of -2.5 SD or below.
Medications:
- Tab. Supracal (Calcium citrate 1000 mg, Cholecalciferol 200 IU, Elemental Magnesium 100 mg, Elemental Zinc 4 mg)1 tablet once a day for 8 weeks.
- Cap. Uprise-D3 60K (Cholecalciferol 60,000 IU) 1 capsule once a week for 8 weeks.
- Tab. Osteofos 70 (Alendronic acid 70 mg) 1 tablet once a week in the morning on empty stomach with lots of water.
- Tab. Dolo 650 (Paracetamol 650 mg) 1 tablet 3-4 times a day for pain relief.
General advice:
- Weight bearing exercises like running, spinning, brisk walking should be started early in the life around the age of 30 years to slow down bone loss.
- Heat fomentation for the painful areas.
- Ultrasonic treatment for painful joints.
Investigations:
- Bone density test – to find out T score and diagnose osteoporosis
- Serum calcium, vitamin D level – to rule out vit D deficiency
- DEXA scan – to rule out focal lesions of osteopenia
- Thyroid function test – to rule out hyperthyroidism as a cause of osteoporosis
- Alkaline phosphatase – raised in altered bone turn over.
- Creatinine – to rule out renal impairment causing impaired vitamin D metabolism hence reduced calcium absorption and bone formation
- Serum protein electrophoresis – in case of osteoporotic fracture to rule out myeloma.
Referral:
- Consider referring to orthopaedic surgeon in case of suspected osteoporotic fractures.
- Consider referring to endocrinologist to rule out endocrinal etiology.