There are different types of bone cells; Osteoclasts which break down bone (resorption of the bone) and Osteoblasts which create new bone (formation of the bone).

Bone is constantly re-modelled and repaired due to damage caused by daily use. Remodelling is a balance process and there is equal amount of bone formation and bone resorption. In osteoporosis the net rate of bone resorption exceed rate of bone formation, these result in loss of bone mass, fragility and consequently bone fracture.

Osteoporosis

Osteoporosis is a progressive systemic skeletal disease characterised by low bone mass and strength of bone with a consequent increase in bone fragility and susceptibility to fracture. Its name comes from Latin for “porous bones.”

Risk factors for Osteoporosis

• Age- bone mineral density (BMD) decreases with age
• Hormones- lower levels of oestrogen after menopause accelerate bone loss
• Premature menopause or hysterectomy (removal of the womb)
• Gender- women are at increased risk of osteoporosis as they start out with smaller bones and bone mass compared to men
• Family history of osteoporotic fracture
• Long term steroid use
• Treatment for breast cancer
• Endocrine problems: Hyperparathyroidism, Hyperthyroidism, Diabetes
• Other medical conditions: Coeliac disease, malabsorption syndromes, inflammatory bowel disease, eating disorders, Kidney diseases, Rheumatoid arthritis and Lupus
• Medicines used for the treatment of stomach ulcer and acid reflux, epilepsy medicines
• Low calcium and vitamin D
• Smoking
• Alcohol
• Low body Weight

Diagnosis of Osteoporosis

All postmenopausal women aged ≥50 years and patient with any of the above risk factors should be assessed for osteoporosis risk. Osteoporosis can be detected on special bone scans such as Dual Energy X-ray Absorptiometry (DEXA) or quantitative CT scan (QCT Bone Mineral Densitometry). Blood tests are performed to rule out other causes of osteoporosis.